Dan Lubman

Changes in opioid and other analgesic prescribing following voluntary and mandatory prescription drug monitoring program implementation: A time series analysis of early outcomes

Publisher: Elsevier BV

Date: 07-2023

DOI: 10.1016/J.DRUGPO.2023.104053

Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

Publisher: MDPI AG

Date: 15-02-2021

DOI: 10.3390/IJERPH18041882

Abstract: Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

Twelve-month outcomes of MAKINGtheLINK: A cluster randomized controlled trial of a school-based program to facilitate help-seeking for substance use and mental health problems

Publisher: Elsevier BV

Date: 2020

DOI: 10.1016/J.ECLINM.2019.11.018

Emotional dysregulation as a target in the treatment of co-existing substance use and borderline personality disorders: A pilot study

Publisher: Informa UK Limited

Date: 07-2018

DOI: 10.1111/CP.12162

Inhibitory control in young adolescents: The role of sex, intelligence, and temperament

Publisher: American Psychological Association (APA)

Date: 05-2012

DOI: 10.1037/A0027693

Abstract: Inhibitory control is associated with temperament and intelligence, which together form an essential component of the ability to adaptively regulate behavior. Impairments in inhibitory control have been linked with a host of common and debilitating conditions, often in a sex-dependent manner. However, sex differences in inhibitory control are often not expressed experimentally during task performance. Here, we sought to examine how sex, temperament, and intelligence are related to different aspects of inhibitory control. We recruited a large s le of early adolescents (n = 153 mean age 12.6 years) to comprehensively investigate the relationship between sex, self-reported and parent-reported temperamental effortful control, and intelligence with different aspects of inhibitory control--namely, strategic (or proactive) control and evaluative (or reactive) control, assessed using a modified Stroop task. Compared with males, females were more efficient in their use of strategic control to reduce the magnitude of response conflict. There was no sex difference in evaluative control. Further, whereas high intelligence was associated with fewer errors for both males and females, effortful control was associated with performance accuracy only in females. These findings highlight sex differences in the relationship of inhibitory control to in idual differences in temperamental effortful control in early adolescents and reinforce the generalized positive effects of intelligence.

The physical and mental health of Australian truck drivers

Publisher: Springer Science and Business Media LLC

Date: 08-03-2022

DOI: 10.1186/S12889-022-12850-5

Abstract: The negative health consequences of truck driving are well documented. However, despite the distinct occupational challenges between long- and short-haul driving, limited research has been conducted on how the health profile of these drivers differ. The aims of this study were to characterise the physical and mental health of Australian truck drivers overall, and to identify any differences in factors influencing the health profile of long-haul compared to short-haul drivers. In this cross-sectional study, 1390 Australian truck drivers completed an online survey between August 2019 and May 2020. Questions included validated measures of psychological distress, general health, work ability and health-related quality-of-life. Participants driving 500 km or more per day were categorised as long-haul and those driving less than 500 km as short-haul. The majority of survey respondents were classified as either overweight (25.2%) or obese (54.3%). Three in ten reported three or more chronic health conditions (29.5%) and poor general health (29.9%). The most commonly diagnosed conditions were back problems (34.5%), high blood pressure (25.8%) and mental health problems (19.4%). Chronic pain was reported by 44% of drivers. Half of drivers reported low levels of psychological distress (50.0%), whereas 13.3 and 36.7% experienced severe or moderate level of psychological distress respectively. There were a small number of differences between the health of long- and short-haul drivers. A higher proportion of short-haul drivers reported severe psychological distress compared to long-haul drivers (15.2% vs 10.4%, χ 2 = 8.8, 0.012). Long-haul drivers were more likely to be obese (63.0% vs 50.9%, χ2 = 19.8, 0.001) and report pain lasting over a year (40.0% vs 31.5%, χ 2 = 12.3, 0.006). Having more than one diagnosed chronic condition was associated with poor mental and physical health outcomes in both long- and short-haul drivers. Australian truck drivers report a high prevalence of multiple physical and mental health problems. Strategies focused on improving diet, exercise and preventing chronic conditions and psychological distress, that can also be implemented within the unique occupational environment of trucking are needed to help improve driver health. Further research is needed to explore risk and protective factors that specifically affect health in both short-haul and long-haul drivers.

Alcohol consumption in tertiary education students

Publisher: Springer Science and Business Media LLC

Date: 09-07-2011

DOI: 10.1186/1471-2458-11-545

Abstract: Heavy alcohol consumption among adolescents and young adults is an issue of significant public concern. With approximately 50% of young people aged 18-24 attending tertiary education, there is an opportunity within these settings to implement programs that target risky drinking. The aim of the current study was to survey students and staff within a tertiary education institution to investigate patterns of alcohol use, alcohol-related problems, knowledge of current National Health and Medical Research Council (NHMRC) guidelines for alcohol consumption and intentions to seek help for alcohol problems. Students of an Australian metropolitan university (with staff as a comparison group) participated in a telephone interview. Questions related to knowledge of NHMRC guidelines, drinking behaviour, alcohol-related problems and help-seeking intentions for alcohol problems. Level of psychological distress was also assessed. Of the completed interviews, 774 (65%) were students and 422 (35%) were staff. While staff were more likely to drink regularly, students were more likely to drink heavily. Alcohol consumption was significantly higher in students, in males and in those with a history of earlier onset drinking. In most cases, alcohol-related problems were more likely to occur in students. The majority of students and staff had accurate knowledge of the current NHMRC guidelines, but this was not associated with lower levels of risky drinking. Psychological distress was associated with patterns of risky drinking in students. Our findings are consistent with previous studies of tertiary student populations, and highlight the disconnect between knowledge of relevant guidelines and actual behaviour. There is a clear need for interventions within tertiary education institutions that promote more effective means of coping with psychological distress and improve help-seeking for alcohol problems, particularly among young men.

Chronic pain medication management of older populations: Key points from a national conference and innovative opportunities for pharmacy practice

Publisher: Elsevier BV

Date: 02-2019

DOI: 10.1016/J.SAPHARM.2018.03.060

Abstract: Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In the pursuit of educating pharmacists, physicians, allied healthcare professionals, researchers, academics and the public facing the challenges of chronic pain medication management, 'The Inaugural Monash University School of Public Health and Preventive Medicine (SPHPM) Best Practice in Chronic Pain Medication Management Day Conference' was held in December 2016 at the Alfred Medical Research and Education Precinct (Melbourne, Australia). Fifteen experts presented on aspects of chronic pain epidemiology and current analgesic use in older Australians, and discussed current practice and associated challenges. Presenters highlighted the dramatic increase in opioid prescribing, development of tolerance and withdrawal symptoms, problems with abuse and addiction, increased risk of death from overdose or suicide, potentiation of sedative effects with concurrent use of anxiolytics/hypnotics, and medication ersion. Pharmacists are very accessible to patients and are crucial members of medication management teams. They have the necessary medication expertise to review medication regimens and provide patient education. Towards addressing chronic pain medication management of older populations, pharmacists can contribute in several ways, such as being aware of relevant guidelines and completing further training, contributing to policy and guideline development, participating in multidisciplinary panels, working groups and pain management teams, collaborating on research projects, and educating the community. With regards to opioid medication management, pharmacists are in an ideal position to: monitor prescription dispensing and potential misuse, provide education about overuse, and, if appropriate, provide access to naloxone. In order to fulfil these roles and responsibilities, allied healthcare professionals should be educated and informed, and opportunities for continuing professional education should be available and utilised. Pharmacists should have the necessary knowledge and skills to optimise chronic pain management, and to both deliver and inform policies and guidelines on pharmacological management of chronic pain in older people.

Politics and science in classifying the dangers of drugs

Publisher: BMJ

Date: 28-10-2010

DOI: 10.1136/EBMH.13.4.97

Abstract: There is a long history of psychoactive substances being regarded as dangerous and subsequently being banned or forbidden. Often the bans were introduced on substances new and unfamiliar to a society, which were viewed as more dangerous than substances which were well known and enculturated. With industrialisation and the globalisation brought by European empires, the growing availability of psychoactive substances was increasingly seen as a problem in the 1800s, setting off social and policy reactions--what we know as the temperance movement against alcohol, and initial UK legislation limiting the sale of 'poisons'.

The Impact of Cannabis Use on Cognitive Functioning in Patients With Schizophrenia: A Meta-analysis of Existing Findings and New Data in a First-Episode Sample

Publisher: Oxford University Press (OUP)

Date: 25-07-2010

DOI: 10.1093/SCHBUL/SBQ079

Pituitary gland volume among heroin users stabilised on substitution pharmacotherapy

Publisher: Elsevier BV

Date: 07-2010

DOI: 10.1016/J.DRUGALCDEP.2010.02.012

Abstract: While long-term heroin addiction is associated with hypothalamus-pituitary-adrenal (HPA) axis dysregulation, few studies have used in vivo brain imaging to examine the impact on pituitary gland volume (PGV) or its relationship with substitution pharmacotherapy. We examined 28 heroin users stable on methadone or buprenorphine and 28 healthy controls. Heroin users exhibited larger PGVs than healthy controls, and this was particularly evident among the buprenorphine-treated group. These findings indicate that substitution pharmacotherapy may have differential effects on normalising HPA axis activity.

Neurobiological and neuropsychological pathways into substance abuse and addictive behavior

Publisher: Cambridge University Press

Date: 10-2009

DOI: 10.1017/CBO9780511642197.027

Workforce Development and E-Competency in Mental Health Services

Publisher: IGI Global

Date: 2016

DOI: 10.4018/978-1-5225-1874-7.CH014

Abstract: Online chat and email are two of the most popular ways of providing e-mental health. Online chat is synchronous communication in a virtual chat room where client and counselor meet at the same time. In contrast, email is referred to as asynchronous because it can be accessed without the synchronous presence of client and counselor. There has been a rapid increase in the demand for chat and email over recent years and much of the demand has been met by services that have traditionally provided helplines or crisis support. This chapter provides an overview of the key issues associated with the delivery of e-mental health services and workforce development. This includes an examination of the range of options for providing e-mental health and key issues to consider when working online. The chapter concludes with a brief exploration of issues associated with client suitability for e-mental health via chat and email.

Implementing mental health screening within a youth alcohol and other drugs service

Publisher: Informa UK Limited

Date: 10-2008

DOI: 10.1080/17523280802275040

Client Experiences of a Telephone-Delivered Intervention for Alcohol Use: a Qualitative Study

Publisher: Springer Science and Business Media LLC

Date: 22-07-2022

DOI: 10.1007/S11469-020-00381-2

Pharmaceutical opioid poisonings in Victoria, Australia: Rates and characteristics of a decade of emergency department presentations among nine pharmaceutical opioids

Publisher: Wiley

Date: 18-09-2021

DOI: 10.1111/ADD.15653

Abstract: Pharmaceutical opioids are a significant contributor to the global ‘opioid crisis’, yet few studies have comprehensively distinguished between opioid types. We measured whether a range of common pharmaceutical opioids varied in their contribution to the rates and characteristics of harm in a population‐wide indicator of non‐fatal overdose. Retrospective observational study of emergency department (ED) patient care records in the Victorian Emergency Minimum Data set (VEMD), July 2009 to June 2019. Victoria, Australia. ED presentations for non‐fatal overdose related to pharmaceutical opioid use ( n = 5403), where the specific pharmaceutical opioid was documented. We compared harms across the nine in idual pharmaceutical opioids most commonly sold, and considered where multiple opioids contributed to the overdose. We calculated supply‐adjusted rates of ED presentations using Poisson regression and used multinomial logistic regression to compare demographic and clinical characteristics of presentations among nine distinct pharmaceutical opioids and a 10th category where multiple opioids were documented for the presentation. There were wide differences, up to 27‐fold, between supply‐adjusted rates of overdose. When considering presentations with sole opioids, the highest supply‐adjusted overdose rates [per 100 000 oral morphine equivalents (OME) 95% confidence interval (CI)] were for codeine (OME = 0.078, 95% CI = 0.073–0.08) and oxycodone (OME =0.029, 95% CI = 0.027–0.030) and the lowest were for tapentadol (OME = 0.004, 95% CI = 0.003–0.006) and fentanyl (OME = 0.003, 95% CI = 0.002–0.004). These rates appeared related to availability rather than opioid potency. Most (62%) poisonings involved females. Codeine, oxycodone and tramadol were associated with younger presentations (respectively, 59.5%, 41.7% and 49.8% of presentations were 12‐34 years old), and intentional self‐harm (respectively 65.2%, 50.6%, and 52.8% of presentations). Relative to morphine, fentanyl [ 0.32 relative risk ratio (RRR)] and methadone ( 0.58 RRR) presentations were less likely to be coded as self‐harm. Relative to morphine–buprenorphine, codeine, oxycodone and tramadol presentations were significantly more likely to be associated with the less urgent triage categories (respectively 2.18, 1.80, 1.52, 1.65 RRR). In Victoria, Australia, rates and characteristics of emergency department presentations for pharmaceutical opioids show distinct variations by opioid type.

‘Holy shit, didn’t realise my drinking was high risk’: an analysis of the way risk is enacted through an online alcohol and drug screening intervention

Publisher: Informa UK Limited

Date: 22-01-2016

DOI: 10.1080/13698575.2015.1130800

Trajectories in suicide attempt method lethality over a five-year period: Associations with suicide attempt repetition, all-cause, and suicide mortality

Publisher: Public Library of Science (PLoS)

Date: 22-01-2021

DOI: 10.1371/JOURNAL.PONE.0245780

Abstract: It is not known if there are discernible patterns in method lethality over successive episodes of self–harm and, if so, how these may be differentially associated with risks of self–harm repetition and suicide. Latent trajectory modelling estimated variation in patterns of suicide attempt lethality in 1,719 in iduals attended by ambulance services on at least three occasions between 2012 and 2016. Cox regression modelling investigated hazards of suicide attempt repetition, all–cause, and suicide mortality as a function of these patterns. Two distinct trajectories provided optimal fit (BIC: –39,464.92). The first (Low/Moderate to Low/Moderate Lethality group 92.5%) consisted of those consistently using methods associated with low to moderate potential lethality throughout the observation period. The second (High to Low/Moderate Lethality group 7.5%) consisted of those who initially used methods with higher potential lethality but who switched to methods characterised by lower lethality. There were no significant differences between groups in the hazards of reattempting suicide (Hazard Ratio [HR] = 1.41, 95% CI 0.76 to 2.59) or all–cause mortality (HR = 1.21, 95% CI 0.63 to 2.32). However, those assigned to the High to Low/Moderate Lethality trajectory group may be at greater risk of suicide (Sub–Hazard Ratio [SHR] = 2.82, 95% CI 1.16 to 6.86). There may be discernible sub–groups of patients with important differences in clinical treatment needs and suicide risk profiles. These differences should be considered when undertaking psychosocial risk/needs assessments with those presenting to clinical services following self-harm.

“Clozapine makes me quite drowsy, so when I wake up in the morning those first cups of coffee are really handy”: an exploratory qualitative study of excessive caffeine consumption among individuals wi

Publisher: Springer Science and Business Media LLC

Date: 16-04-2014

DOI: 10.1186/1471-244X-14-116

Development and Implementation of a Structured Intervention for Alcohol Use Disorders for Telephone Helpline Services

Publisher: Informa UK Limited

Date: 02-01-2015

DOI: 10.1080/07347324.2015.986424

Tobacco Smoking within Psychiatric Inpatient Settings: Biopsychosocial Perspective

Publisher: SAGE Publications

Date: 07-2007

DOI: 10.1080/00048670701392809

Abstract: Tobacco smoking remains a neglected issue within general psychiatry despite high rates of associated morbidity and mortality. While there has been a coordinated community c aign to reduce tobacco smoking within the general population, mental health facilities have been reluctant to adopt such regulatory controls, and rarely target smoking prevention or treatment. This paper summarizes and discusses evidence relating to the clinical impact of tobacco smoking within inpatient psychiatric settings. A selective review of psychiatric and psychological research on smoking within inpatient settings was conducted, with a particular focus on the influence of smoking on the physical and mental health, pharmacotherapy, and social interactions of patients during their inpatient stay. Patients frequently alter their smoking habits during inpatient treatment, which can affect both their presentation and pharmacotherapeutic management. Smoking also appears to play a central role in social interactions on the ward, with staff frequently using cigarettes to reinforce certain behaviours. Despite current guidelines, mental health professionals rarely address nicotine use among their patients. Nevertheless, programmes that assist patients to quit during an inpatient stay have been shown to be both efficacious and cost-effective. Strategies that address staff concerns and assist in the implementation of effective smoking bans on psychiatric units are also available. Cessation should be a key component of inpatient treatment planning because this setting provides a safe and timely opportunity to help patients quit. A flowchart of interventions that could be incorporated within standard inpatient settings is proposed.

Persistent downregulation of hippocampal CREB mRNA parallels a Y-maze deficit in adolescent rats following semi-chronic amphetamine administration

Publisher: Wiley

Date: 05-2008

DOI: 10.1038/BJP.2008.126

A study protocol for the N-ICE trial: A randomised double-blind placebo-controlled study of the safety and efficacy of N-acetyl-cysteine (NAC) as a pharmacotherapy for methamphetamine (“ice”) dependen

Publisher: Springer Science and Business Media LLC

Date: 04-06-2019

DOI: 10.1186/S13063-019-3450-0

Anxiety and substance use disorders: A worrying combination

Publisher: SAGE Publications

Date: 08-2015

DOI: 10.1177/1039856215590053

Abstract: In iduals with co-occurring substance use and anxiety disorders can present as a diagnostic challenge. This article aims to provide clinicians with an overview of practical approaches to assessment and treatment of this common co-morbidity. A comprehensive assessment can assist in formulating a holistic management plan that incorporates adapted psychological and pharmacological therapies to address both substance use and anxiety disorders in an integrated manner.

Cross-sectional analysis of sleep-promoting and wake-promoting drug use on health, fatigue-related error, and near-crashes in police officers

Publisher: BMJ

Date: 09-2018

DOI: 10.1136/BMJOPEN-2018-022041

Abstract: To examine sleep-promoting and wake-promoting drug use in police officers and associations between their use and health (excessive sleepiness, stress and burnout), performance (fatigue-related errors) and safety (near-crashes) outcomes, both alone and in combination with night-shift work. Cross-sectional survey. Police officers from North America completed the survey either online or via paper encil at a police station. 4957 police participated, 3693 online (91.9%, participation rate) and 1264 onsite (cooperation rate 63.1%). Sleep-promoting and wake-promoting drug use, excessive sleepiness, near-crash motor vehicle crashes, dozing while driving, fatigue errors, stress and burnout. Over the past month, 20% of police officers reported using sleep-promoting drugs and drugs causing sleepiness, while wake-promoting agents were used by 28% of police (5% used wake-promoting drugs, 23% used high levels of caffeine and 4% smoked to stay awake). Use of sleep-promoting drugs was associated with increased near-crashes (OR=1.61 95% CI 1.21 to 2.13), fatigue-related errors (OR=1.75 95% CI 1.32 to 2.79), higher stress (OR=1.41 95% CI 1.10 to 1.82), and higher burnout (OR=1.83 95% CI 1.40 to 2.38). Wake-promoting drug use, high caffeine and smoking to stay awake were associated with increased odds of a fatigue-related error, stress and burnout (ORs ranging from 1.68 to 2.56). Caffeine consumption was common, and while smoking was not, of those participants who did smoke, one-in-three did so to remain awake. Night-shift work was associated with independent increases in excessive sleepiness, near-crashes and fatigue-related errors. Interactions between night-shift work and wake-promoting drug use were also found for excessive sleepiness. Police who use sleep-promoting and wake-promoting drugs, especially when working night shifts, are most vulnerable to adverse health, performance and safety outcomes. Future research should examine temporal relationships between shift work, drug use and adverse outcomes, in order to develop optimal alertness management strategies.

“Is it me or should my friends take the credit?” The role of social networks and social identity in recovery from addiction

Publisher: Wiley

Date: 2017

DOI: 10.1111/JASP.12420

An Examination of Clinician Responses to Problem Gambling in Community Mental Health Services

Publisher: MDPI AG

Date: 07-2020

DOI: 10.3390/JCM9072075

Abstract: Gambling problems commonly co-occur with other mental health problems. However, screening for problem gambling (PG) rarely takes place within mental health treatment settings. The aim of the current study was to examine the way in which mental health clinicians respond to PG issues. Participants (n = 281) were recruited from a range of mental health services in Victoria, Australia. The majority of clinicians reported that at least some of their caseload was affected by gambling problems. Clinicians displayed moderate levels of knowledge about the reciprocal impact of gambling problems and mental health but had limited knowledge of screening tools to detect PG. Whilst 77% reported that they screened for PG, only 16% did so “often” or “always” and few expressed confidence in their ability to treat PG. However, only 12.5% reported receiving previous training in PG, and those that had, reported higher levels of knowledge about gambling in the context of mental illness, more positive attitudes about responding to gambling issues, and more confidence in detecting/screening for PG. In conclusion, the findings highlight the need to upskill mental health clinicians so they can better identify and manage PG and point towards opportunities for enhanced integrated working with gambling services.

Cerebellar white-matter changes in cannabis users with and without schizophrenia

Publisher: Cambridge University Press (CUP)

Date: 05-04-2011

DOI: 10.1017/S003329171100050X

Abstract: The cerebellum is rich in cannabinoid receptors and implicated in the neuropathology of schizophrenia. Long-term cannabis use is associated with functional and structural brain changes similar to those evident in schizophrenia, yet its impact on cerebellar structure has not been determined. We examined cerebellar grey and white matter in cannabis users with and without schizophrenia. Seventeen patients with schizophrenia and 31 healthy controls were recruited 48% of the healthy group and 47% of the patients were long-term heavy cannabis users (mean 19.7 and 17.9 years near daily use respectively). Cerebellar measures were extracted from structural 3-T magnetic resonance imaging (MRI) scans using semi-automated methods, and examined using analysis of covariance (ANCOVA) and correlational analyses. Cerebellar white-matter volume was reduced in cannabis users with and without schizophrenia compared to healthy non-users, by 29.7% and 23.9% respectively, and by 17.7% in patients without cannabis use. Healthy cannabis users did not differ in white-matter volume from either of the schizophrenia groups. There were no group differences in cerebellar grey matter or total volumes. Total cerebellar volume decreased as a function of duration of cannabis use in the healthy users. Psychotic symptoms and illness duration correlated with cerebellar measures differentially between patients with and without cannabis use. Long-term heavy cannabis use in healthy in iduals is associated with smaller cerebellar white-matter volume similar to that observed in schizophrenia. Reduced volumes were even more pronounced in patients with schizophrenia who use cannabis. Cannabis use may alter the course of brain maturational processes associated with schizophrenia.

Investigating Differences Between Drugs Used in the Australian Night-Time Economy: Demographics, Substance Use, and Harm.

Publisher: Informa UK Limited

Date: 26-09-2017

DOI: 10.1080/10826084.2016.1214153

Abstract: Understanding the characteristics of drug users in the night-time economy (NTE), and whether particular drugs are associated with risky practices and experience of harm, is necessary to inform targeted policy responses in this context. To investigate the correlates of drugs used in the Australian NTE relating to demographics, alcohol use, and experience of harm. Patrons were interviewed in the NTE of five Australian cities in 2012-2013 (n = 7,028 61.9% male, median age 22 years). A custom designed survey gathered demographic data, alcohol, and substance use on the current night, and experience of harm in/around licensed venues in the past 3 months. Multivariate logistic regression analyses examined the correlates of drug use. Ecstasy was most commonly reported (4.0%), followed by cannabis (2.9%), meth hetamine (2.6%), and cocaine (1.6%). Ecstasy users were more likely to be younger and report energy drink consumption. Cannabis users were more likely to be male, and to have been involved in intoxication-related accidents/injuries and sexual aggression in/around licensed venues in the past 3 months. Meth hetamine users were more likely to have been interviewed later, and to have engaged in pre-drinking. Cocaine users were more likely to be male, aged 21 years or more, have a blood alcohol concentration of greater than 0.10%, and to have been involved in intoxication-related accidents/injuries in the past three months. Conclusions/Importance: We identified significant differences between types of drug users and the harms they experience, underscoring the need to develop innovative harm reduction policies in the NTE rather than blanket population-based approaches.

A randomized controlled trial of bibliotherapy for carers of young people with first-episode psychosis

Publisher: Oxford University Press (OUP)

Date: 20-11-2013

DOI: 10.1093/SCHBUL/SBS121

Attention to pleasant stimuli in early adolescence predicts alcohol-related problems in mid-adolescence

Publisher: Elsevier BV

Date: 05-2015

DOI: 10.1016/J.BIOPSYCHO.2015.03.014

Abstract: Attenuated responses to natural rewards have been found to predict subsequent substance use among dependent populations, suggesting that this may be a premorbid risk factor for later problematic substance use. However, research on adolescent risk-taking suggests that exaggerated, rather than blunted, reward responsiveness predicts later substance abuse. Acoustic startle-induced event-related potentials (ERP) were recorded in a s le of 11-13 year-olds while they viewed affective pictures, and participants were reassessed four years later regarding alcohol use and experience of alcohol-related problems. Increased attenuation of the litude of the P300 component of the ERP during viewing of pleasant pictures, relative to litude during neutral pictures (an indicator of increased attention to pleasant pictures), predicted increased likelihood of alcohol-related problems at follow-up. These findings further support research indicating that increased reward responsiveness predicts risky behaviours in adolescence, with anhedonia primarily a consequence of substance dependence.

Typology of Alcohol Mixed with Energy Drink Consumers: Motivations for Use

Publisher: Wiley

Date: 18-05-2015

DOI: 10.1111/ACER.12729

Abstract: Previous research on alcohol mixed with energy drinks (AmED) has shown that use is typically driven by hedonistic, social, functional, and intoxication-related motives, with differential associations with alcohol-related harm across these constructs. There has been no research looking at whether there are subgroups of consumers based on patterns of motivations. Consequently, the aims were to determine the typology of motivations for AmED use among a community s le and to identify correlates of subgroup membership. In addition, we aimed to determine whether this structure of motivations applied to a university student s le. Data were used from an Australian community s le (n = 731) and an Australian university student s le (n = 594) who were identified as AmED consumers when completing an online survey about their alcohol and ED use. Participants reported their level of agreement with 14 motivations for AmED use latent classes of AmED consumers were identified based on patterns of motivation endorsement using latent class analysis. A 4-class model was selected using data from the community s le: (i) taste consumers (31%): endorsed pleasurable taste (ii) energy-seeking consumers (24%): endorsed functional and taste motives (iii) hedonistic consumers (33%): endorse pleasure and sensation-seeking motives, as well as functional and taste motives and (iv) intoxication-related consumers (12%): endorsed motives related to feeling in control of intoxication, as well as hedonistic, functional, and taste motives. The consumer subgroups typically did not differ on demographics, other drug use, alcohol and ED use, and AmED risk taking. The patterns of motivations for the 4-class model were similar for the university student s le. This study indicated the existence of 4 subgroups of AmED consumers based on their patterns of motivations for AmED use consistently structured across the community and university student s le. These findings lend support to the growing conceptualization of AmED consumers as a heterogeneous group in regard to motivations for use, with a hierarchical and cumulative class order in regard to the number of types of motivation for AmED use. Prospective research may endeavor to link session-specific motives and outcomes, as it is apparent that primary consumption motives may be fluid between sessions.

The impact of problematic substance use on partners’ interpersonal relationships: qualitative analysis of counselling transcripts from a national online service

Publisher: Informa UK Limited

Date: 31-05-2019

DOI: 10.1080/09687637.2018.1472217

The Role of Peers on School-Based Prevention Programs Targeting Adolescent Substance Use

Publisher: Springer Science and Business Media LLC

Date: 14-08-2017

DOI: 10.1007/S40429-017-0165-8

The right place at the right time: The social contexts of combined alcohol and energy drink use

Publisher: Informa UK Limited

Date: 31-03-2016

DOI: 10.3109/09687637.2016.1156650

QuitNic: A Pilot Randomized Controlled Trial Comparing Nicotine Vaping Products With Nicotine Replacement Therapy for Smoking Cessation Following Residential Detoxification

Publisher: Oxford University Press (OUP)

Date: 08-08-2020

DOI: 10.1093/NTR/NTAA143

Abstract: The QuitNic pilot trial aimed to test the feasibility of providing a nicotine vaping product (NVP) compared with combination nicotine replacement therapy (NRT) to smokers upon discharge from a smoke-free residential substance use disorder (SUD) treatment service. QuitNic was a pragmatic two-arm randomized controlled trial. At discharge from residential withdrawal, 100 clients received telephone Quitline behavioral support and either 12-week supply of NRT or an NVP. Treatment adherence and acceptability, self-reported abstinence, cigarettes smoked per day (CPD), frequency of cravings, and severity of withdrawal symptoms were assessed at 6 and 12 weeks. Results are reported for complete cases and for abstinence outcomes, penalized imputation results are reported where missing is assumed smoking. Retention on was 63% at 6 weeks and 50% at 12 weeks. At 12 weeks, 68% of the NRT group reported using combination NRT while 96% of the NVP group used the device. Acceptability ratings for the products were high in both groups. At 12 weeks, 14% of the NVP group and 18% of the NRT group reported not smoking at all in the last 7 days. Mean CPD among continued smokers decreased significantly between baseline to 12 weeks in both groups from 19.91 to 4.72 for the NVP group (p & .001) and from 20.88 to 5.52 in the NRT group (p & .001). Cravings and withdrawal symptoms significantly decreased for both groups. Clients completing residential withdrawal readily engaged with smoking cessation post-treatment when given the opportunity. Further research is required to identify the most effective treatments postwithdrawal for this population at elevated risk of tobacco-related harm. ACTRN12617000849392 This pilot study showed that smoking cessation support involving options for nicotine replacement and Quitline-delivered cognitive behavioral counseling is attractive to people after they have been discharged from SUD treatment. Both nicotine vaping products and nicotine replacement therapies were highly acceptable and used by participants who reported reductions in cravings for cigarettes and perceptions of withdrawal symptoms and reductions in number of cigarettes smoked. Some participants self-reported abstinence from cigarettes—around one in five reported having quit smoking cigarettes at 12 weeks postdischarge. The results have significant public health implications for providing quit support following discharge from SUD treatment.

Staying with the silence: Silence as affording care in online alcohol and other drug counselling

Publisher: Elsevier BV

Date: 06-2023

DOI: 10.1016/J.DRUGPO.2023.104030

Psychosocial risk factors for inconsistent condom use in young people with first episode psychosis

Publisher: Springer Science and Business Media LLC

Date: 19-01-2011

DOI: 10.1007/S10597-011-9370-4

Abstract: There is evidence of high rates of unprotected sex among young people with first episode psychosis compared to their peers. Little research has explored factors associated with condom use in this population. The current study examined the association between previously identified psychosocial risk factors and condom use in young people with early psychosis and their peers. Sixty-seven sexually active young people with first episode psychosis and 48 sexually active control participants matched on a number of sociodemographic factors completed a self-report survey. Increased probability of inconsistent condom use was associated with clinical status, younger age, unemployment, and the absence of peer support for condom use. Psychological distress, self-esteem, social support, substance use, and impulsivity were not associated with condom use. The results suggest that sexual risk-reduction interventions for young people with psychosis should target peer norms, particularly among those who are younger and unemployed.

The therapist experience of internet delivered CBT for problem gambling: Service integration considerations

Publisher: Elsevier BV

Date: 1970

DOI: 10.1016/J.INVENT.2019.100264

Does cannabis cause lasting brain damage?

Publisher: Cambridge University Press

Date: 27-10-2011

DOI: 10.1017/CBO9780511706080.010

The prevalence of psychotic symptoms among methamphetamine users

Publisher: Wiley

Date: 09-2006

DOI: 10.1111/J.1360-0443.2006.01496.X

Abstract: To examine the prevalence of psychotic symptoms among regular meth hetamine users. Cross-sectional survey. Participants were recruited from Sydney, Australia, through advertisements in free-press magazines, flyers and through word-of-mouth. Meth hetamine users (n = 309) who were aged 16 years or over and took the drug at least monthly during the past year. A structured face-to-face interview was used to assess drug use, demographics and symptoms of psychosis in the past year. Measures of psychosis included: (a) a psychosis screening instrument derived from the Composite International Diagnostic Interview and (b) the Brief Psychiatric Rating Scale subscales of suspiciousness, unusual thought content, and hallucinations. Dependence on meth hetamine was measured using the Severity of Dependence Scale. Thirteen per cent of participants screened positive for psychosis, and 23% had experienced a clinically significant symptom of suspiciousness, unusual thought content or hallucinations in the past year. Dependent meth hetamine users were three times more likely to have experienced psychotic symptoms than their non-dependent counterparts, even after adjusting for history of schizophrenia and other psychotic disorders. The prevalence of psychosis among the current s le of meth hetamine users was 11 times higher than among the general population in Australia. Dependent meth hetamine users are a particularly high-risk group for psychosis.

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing?

Publisher: Wiley

Date: 28-07-2016

DOI: 10.1111/ADD.13014

Abstract: Motivational interviewing (MI) is the most successfully disseminated evidence-based practice in the substance use disorder (SUD) treatment field. This systematic review considers two questions relevant to policymakers and service providers: (1) does training in MI achieve sustained practice change in clinicians delivering SUD treatment and (2) do clinicians achieve a level of competence after training in MI that impacts upon client outcomes? A systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, examining training outcomes for MI in the SUD treatment sector, and for clinicians working in a SUD treatment role. We determined a training method to have resulted in sustained practice change when over 75% of participants met beginning proficiency in MI spirit at a follow-up time-point. Of the 20 studies identified, 15 measured training at a follow-up time-point using standard fidelity measures. The proportion of clinicians who reached beginning proficiency was either reported or calculated for 11 of these studies. Only two studies met our criterion of 75% of clinicians achieving beginning proficiency in MI spirit after training. Of the 20 studies identified, two measured client substance use outcomes with mixed results. A broad range of training studies failed to achieve sustained practice change in MI according to our criteria. It is unlikely that 75% of clinicians can achieve beginning proficiency in MI spirit after training unless competency is benchmarked and monitored and training is ongoing. The impact of training on client outcomes requires future examination.

Adverse outcomes of GHB use: Analysis of ambulance attendances in metropolitan and regional Victoria

Publisher: Elsevier BV

Date: 2023

DOI: 10.1016/J.DRUGPO.2022.103932

Affected family member coping with a relative with alcohol and/or other drug misuse: A cross-sectional survey questionnaire

Publisher: Wiley

Date: 18-12-2019

DOI: 10.1111/INM.12567

Abstract: Families have a crucial role supporting a relative with alcohol and/or other drug misuse, but the role has adverse implications for family members' coping, which in turn, affects their ability and willingness to support the relative. The aim of this study was to assess the coping behaviours of affected family members of relatives with alcohol and/or other drug misuse and to assess if there was a relationship between the level of coping and family member type and support-giving experience. A cross-sectional survey design was used, and 90 respondents completed the questionnaire. Results suggest the following associations: that 'Other' family members made more frequent use of maladaptive coping strategies than intimate partners (P = 0.012) family members whose role had a negative effect on their physical health made more frequent use of maladaptive coping strategies than those whose role did not have this effect (P = 0.014) and family members whose role had a negative effect on their ability to socialise used maladaptive coping strategies more often than those whose role did not have this effect (P = 0.003). Engaged and tolerant-inactive maladaptive coping strategies had a significantly greater adverse influence on family members' physical health and/or socialising than withdrawal coping strategies. Affected family members should be supported to use adaptive coping strategies to mitigate the detrimental effects of their support-giving role and to sustain them in this crucial support-giving role. Family and friends, mental health nurses, and other clinicians in the alcohol and other drug field have an important role in supporting family members in this context.

First-Time Primary Caregivers' Experience of Caring for Young Adults With First-Episode Psychosis

Publisher: Oxford University Press (OUP)

Date: 13-08-2009

DOI: 10.1093/SCHBUL/SBP085

Outcomes of reducing stigma towards alcohol misuse during adolescence: results of a randomized controlled trial of the MAKINGtheLINK intervention

Publisher: Springer Science and Business Media LLC

Date: 21-03-2020

DOI: 10.1186/S13034-020-00317-7

Abstract: While it is well-recognized that the stigma associated with alcohol use problems can prevent or delay help-seeking, there is limited research examining stigmatising attitudes towards alcohol misuse, or their consequences, during adolescence. The current study examined the results of a school-based intervention on adolescents’ stigmatising attitudes towards alcohol misuse among their peers, and how changes in attitudes influenced intentions to encourage help-seeking, as well as participants’ personal use and misuse of alcohol. Participants (n = 463) were a subset of a larger s le participating in a randomized controlled trial of the MAKINGtheLINK intervention. Of the included participants, 287 (62%) were allocated to the intervention group and 176 (38%) to the control group. Assessments were conducted at baseline and 6-weeks, 6-months, and 12-months post-baseline. At each assessment, participants were presented with a vignette describing a peer experiencing alcohol misuse and completed the General Help Seeking Questionnaire as well as a 10-item scale measuring stigmatising attitudes. Alcohol use was also assessed. The intervention was associated with a greater reduction in ‘weak-not-sick’ attitudes over time, which in turn predicted stronger intentions to encourage help-seeking from family members and formal help sources at the 12-month follow-up. Perceptions of dangerousness did not change significantly as a result of the intervention, however overall perceptions of dangerousness demonstrated a trend towards encouraging help-seeking from formal sources. Changes in stigma were not associated with past-year alcohol use or problems. School-based interventions such as MAKINGtheLINK can decrease some stigmatising attitudes towards alcohol misuse during adolescence, and increase adolescents’ intentions to encourage help-seeking from both formal and informal help sources. However, results varied depending on both the dimension of stigma examined and the type of help source, highlighting a complex relationship between stigma, intentions, and sources of help that requires further investigation. Importantly, reducing stigma did not appear to result in negative effects due to greater acceptance of drinking (e.g., heavier alcohol use), supporting continued efforts to reduce alcohol-related stigma during adolescence. Trial registration : Registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (ACTRN12613000235707)

Aggression and violence at ambulance attendances where alcohol, illicit and/or pharmaceutical drugs were recorded: A 5-year study of ambulance records in Victoria, Australia

Publisher: Elsevier BV

Date: 12-2019

DOI: 10.1016/J.DRUGALCDEP.2019.107685

Abstract: This study describes the frequency and characteristics of aggression and/or violence in ambulance attendances involving alcohol, illicit and/or pharmaceutical drug use in Victoria, Australia between January 2012 and January 2017. Patient characteristics, context, and substance use involvement in ambulance attendances were examined to determine associations with attendances where aggression and/or violence was recorded. There were 205,178 ambulance attendances where use of alcohol, pharmaceutical drugs or illicit substances contributed to the reason for the attendance. Paramedics recorded acts of aggression and/or violence in 11,813 (5.76 %) of these attendances. Aggression/violence was more likely to be recorded in certain contexts. Compared with attendances where aggression/violence was not recorded, attendances where aggression/violence was recorded were significantly more likely to involve younger and male patients, and occur on Friday and Saturday nights. Alcohol intoxication was involved in more than half of attendances where aggression/violence was recorded, and was almost twice as prevalent as those involving illicit drug use where aggression/violence was recorded. This pattern was consistent across all hours, high-alcohol hours only, by metropolitan/regional location, and by police co-attendance. Aggression and violence are frequently recorded in ambulance attendances involving alcohol, pharmaceutical drugs or illicit substances, and, most often involve alcohol. This violence poses a recurring threat to the health and safety of paramedics, bystanders, and patients. Greater priority should be given to reducing alcohol-related violence through evidence-based policy measures targeting high-risk groups (e.g. young adult males) and contexts (e.g. weekends, late at night) where harm is most likely to occur.

Emergency management of inadvertent accelerated opiate withdrawal in dependent opiate users

Publisher: Wiley

Date: 12-2003

DOI: 10.1080/09595230310001613958

A structured telephone-delivered intervention to reduce problem alcohol use (Ready2Change): Study protocol for a parallel group randomised controlled trial

Publisher: Springer Science and Business Media LLC

Date: 19-08-2019

DOI: 10.1186/S13063-019-3462-9

Paramedics' perceptions of their scope of practice in caring for patients with nonmedical emergency-related mental health and/or alcohol and other drug problems: A qualitative study

Publisher: Public Library of Science (PLoS)

Date: 13-12-2018

DOI: 10.1371/JOURNAL.PONE.0208391

Do advertising and promotions for online gambling increase gambling consumption? An exploratory study

Publisher: Informa UK Limited

Date: 15-04-2014

DOI: 10.1080/14459795.2014.903989

Reflection impulsivity in adolescent cannabis users: A comparison with alcohol-using and non-substance-using adolescents

Publisher: Springer Science and Business Media LLC

Date: 21-09-2012

DOI: 10.1007/S00213-011-2486-Y

Abstract: Reflection impulsivity-a failure to gather and evaluate information before making a decision-is a critical component of risk-taking and substance use behaviours, which are highly prevalent during adolescence. The Information S ling Test was used to assess reflection impulsivity in 175 adolescents (mean age 18.3, range 16.5-20 55% female)-48 cannabis users (2.3 years use, 10.8 days/month), 65 alcohol users, and 62 non-substance-using controls-recruited from a longitudinal cohort and from the general community and matched for education and IQ. Cannabis and alcohol users were matched on levels of alcohol consumption. Cannabis users s led to the lowest degree of certainty before making a decision on the task. Group differences remained significant after controlling for relevant substance use and clinical confounds (e.g., anxiety, depressive symptoms, alcohol, and ecstasy use). Poor performance on multiple IST indices was associated with an earlier age of onset of regular cannabis use and greater duration of exposure to cannabis, after controlling for recent use. Alcohol users did not differ from controls on any IST measure. Exposure to cannabis during adolescence is associated with increased risky and impulsive decision making, with users adopting strategies with higher levels of uncertainty and inefficient utilisation of information. The young cannabis users did show sensitivity to losses, suggesting that greater impulsivity early in their drug using career is more evident when there is a lack of negative consequences. This provides a window of opportunity for intervention before the onset of cannabis dependence.

Patron offending and intoxication in night-time entertainment districts (POINTED)

Publisher: International Journal of Alcohol and Drug Research

Date: 08-03-2013

DOI: 10.7895/IJADR.V2I1.74

Abstract: Miller, P., Pennay, A., Jenkinson, R., Droste, N., Chikritzhs, T., Tomsen, S., Wadds, P., Jones, S. C., Palmer, D., Barrie, L. & Lubman, D. I. (2013). Patron offending and intoxication in night-time entertainment districts (POINTED): A study protocol. International Journal of Alcohol and Drug Research, 2(1), 69-76. doi: 10.7895/ijadr.v2i1.74 (0.7895/ijadr.v2i1.74)Risky alcohol consumption is the subject of considerable community concern in Australia and internationally, particularly the risky drinking practices of young people consuming alcohol in the night-time economy. This study will determine some of the factors and correlates associated with alcohol-related risk-taking, offending and harm in and around licensed venues and night-time entertainment precincts across five Australian cities (three metropolitan and two regional). The primary aim of the study is to measure levels of pre-drinking, drinking in venues, intoxication, illicit drug use and potentially harmful drinking practices (such as mixing with energy drinks) of patrons in entertainment areas, and relating this to offending, risky behaviour and harms experienced. The study will also investigate the effects of license type, trading hours, duration of drinking episodes and geographical location on intoxication, offending, risk-taking and experience of harm. Data collection involves patron interviews (incorporating breathalysing and drug testing) with 7500 people attending licensed venues. Intensive venue observations (n=112) will also be undertaken in a range of venues, including pubs, bars and nightclubs. The information gathered through this study will inform prevention and enforcement approaches of policy makers, police and venue staff.

Anomalies in global network connectivity associated with early recovery from alcohol dependence: A network transcranial magnetic stimulation and electroencephalography study

Publisher: Wiley

Date: 27-02-2022

DOI: 10.1111/ADB.13146

Abstract: Although previous research in alcohol dependent populations identified alterations within local structures of the addiction ‘reward’ circuitry, there is limited research into global features of this network, especially in early recovery. Transcranial magnetic stimulation (TMS) is capable of non‐invasively perturbing the brain network while electroencephalography (EEG) measures the network response. The current study is the first to apply a TMS inhibitory paradigm while utilising network science (graph theory) to quantify network anomalies associated with alcohol dependence. Eleven in iduals with alcohol‐dependence (ALD) in early recovery and 16 healthy controls (HC) were administered 75 single pulses and 75 paired‐pulses (inhibitory paradigm) to both the left and right prefrontal cortex (PFC). For each participant, Pearson cross‐correlation was applied to the EEG data and correlation matrices constructed. Global network measures (mean degree, clustering coefficient, local efficiency and global efficiency) were extracted for comparison between groups. Following administration of the inhibitory paired‐pulse TMS to the left PFC, the ALD group exhibited altered mean degree, clustering coefficient, local efficiency and global efficiency compared to HC. Decreases in local efficiency increased the prediction of being in the ALD group, while all network metrics (following paired‐pulse left TMS) were able to adequately discriminate between the groups. In the ALD group, reduced mean degree and global clustering was associated with increased severity of past alcohol use. Our study provides preliminary evidence of altered network topology in patients with alcohol dependence in early recovery. Network anomalies were predictive of high alcohol use and correlated with clinical features of alcohol dependence. Further research using this novel brain mapping technique may identify useful network biomarkers of alcohol dependence and recovery.

Putting 'addiction' back into psychiatry

Publisher: SAGE Publications

Date: 2008

DOI: 10.1080/10398560701760227

Abstract: Objective: The aim of this paper is to provide an overview of the history and activities of the RANZCP Section of Addiction Psychiatry, as well as its current challenges and opportunities. Conclusions: From initial exclusion to an active and growing membership, the Section of Addiction Psychiatry continues to ensure that problematic substance use and gambling remain core issues within Australasian psychiatry. In addition to commenting and contributing to ongoing clinical and policy initiatives, the Section has recently introduced an advanced training curriculum and maintains a strong partnership with the relatively new Australasian Chapter of Addiction Medicine. Its active input into education, training, media and policy development within the College guarantees that psychiatry is represented within the addiction field, and that tomorrow's psychiatrists are competent to assess and treat comorbid addiction issues.

Alcohol problems among migrants in substance use treatment: The role of drinking patterns in countries of birth

Publisher: CSIRO Publishing

Date: 2014

DOI: 10.1071/PY14028

Abstract: Migrants’ beliefs about when to seek help for alcohol problems may differ from host-country norms. We undertook an audit of 393 cases of screening in specialist alcohol and other drug services in Victoria, Australia, to examine whether alcohol problem severity at the time of help-seeking was influenced by drinking norms in countries of birth. Alcohol problem severity was measured using the Alcohol Use Disorders Identification Test, and World Health Organization per capita alcohol consumption data was used to form three categories of clients relative to Australian consumption: (1) Australian born (2) born in low alcohol consumption countries and (3) born in high alcohol consumption countries. Clients born in high consumption countries such as those in Europe and the UK had significantly higher levels of alcohol problem severity at intake compared with Australian-born clients and clients born in low consumption countries. This suggests that clients from high consumption countries might have delayed seeking help in line with the alcohol norms in their country of origin. Screening this group for alcohol problems in primary health care might avoid significant cumulative harm.

Development of Goal Management Training+ (GMT+) for Methamphetamine Use Disorder Through Collaborative Design: A Process Description

Publisher: Cold Spring Harbor Laboratory

Date: 05-08-2021

DOI: 10.1101/2021.08.01.21261454

Abstract: Meth hetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes including earlier drop out and relapse. However, current treatments for MUD do not address executive functions. Goal Management Training (GMT) is an evidence-based cognitive remediation program for executive dysfunction but required modifications to enhance its relevance and application within addiction treatment settings. This study aimed to 1) tailor GMT to the key cognitive deficits and typical treatment duration of MUD 2) explore consumers’ (people with MUD) engagement with the revised program 3) implement a protocol of the program with consumers and 4) present the manualised standard administration to clinical service providers. We followed the Medical Research Council Complex Interventions Framework and employed an evidence- and person-based intervention development process. We used a four-phased approach and collaborated with neuropsychology experts, design researchers in healthcare, consumers with MUD, and clinical service providers. Each aim was addressed in a separate study phase including content refinement and review with neuropsychology experts (phase 1), intervention design and collaboration with consumers (phase 2), prototype development and review with consumers (phase 3), and final program modifications and review with clinical stakeholders (phase 4). Findings from phase 1 indicated support for targeting four cognitive processes (attention, impulse control, goal setting, and decision-making). Key feedback included the need to help habitualise program strategies and guide consumers in applying them in emotionally salient situations. Findings from phases 2 and 3 indicated consumer support for the program strategies and materials but highlighted the need to further enhance the personal relevance of specific content and journal activities. Findings from phase 4 provided overall clinical support for the revised program but indicated an opportunity to minimise unintended effects. We present the intervention materials for the revised program, Goal Management Training + (GMT + ), in line with TIDieR guidelines. GMT + targets tailored cognitive processes, includes reimagined materials and activities, and is sensitive to the clinical needs of people with MUD. Our intervention development process was important for informing the training components, design and intervention materials, and indicating initial acceptability prior to conducting a clinical trial.

Solvent-Induced Leukoencephalopathy: A Disorder of Adolescence?

Publisher: Informa UK Limited

Date: 24-05-2011

DOI: 10.3109/10826084.2011.580216

Abstract: Volatile substance misuse is common during early adolescence however, limited work has been conducted investigating the neurobiological effects of such use on the developing brain. While both animal and human studies report cognitive and neurobiological harm associated with volatile substance misuse during adolescence (particularly involving white matter structures), the complex psychosocial characteristics of volatile substance misusers confound the specificity of reported volatile substance-related pathology in human subjects. In addition, few studies have examined whether cognitive and neurobiological recovery occurs with abstinence, although there is some literature indicating that neurological and cognitive improvement is possible, but relates to the frequency and duration of previous use. Longitudinal studies utilizing well-matched control s les are required to fully delineate the short- and long-term impact of volatile substance misuse on adolescent brain development.

Enhancing the utility of the problem gambling severity index in clinical settings: Identifying refined categories within the problem gambling category

Publisher: Elsevier BV

Date: 04-2020

DOI: 10.1016/J.ADDBEH.2019.106257

Abstract: The Problem Gambling Severity Index (PGSI) was intended for use in epidemiological research with gamblers across the continuum of risk. Its utility within clinical settings, where the majority of clients are problem gamblers, has been brought into question. (1) Identify refined categories for the problem gambling category of the PGSI in help-seeking gamblers (2) Validate these categories using the Gambling Symptom Assessment Scale (G-SAS) (3) Explore the relationship of these categories with indices of gambling and help-seeking behaviour. Secondary data analysis of help-seeking problem gamblers from the Australian online gambling counselling/support service (Gambling Help Online [GHO]) from October 2012 to December 2015 (n = 5,881) and trial data evaluating an Australian online self-directed program for gambling (GamblingLess n = 198). Both datasets included the PGSI, gambling frequency and expenditure. The GamblingLess dataset also included the G-SAS and help-seeking behaviour. A Latent Class Analysis, using GHO data, identified a 2-class solution. Multiple analytical methods identified a cut-off value of ≥ 19 distinguishing this 2-class solution (low problem severity: Median = 16 high problem severity: Median = 23). High problem severity gamblers had increased odds of being categorised in the higher GSAS category, greater gambling expenditure and having sought face-to-face support. The refined categories were not associated with gambling frequency, distance-based or self-directed help-seeking. These findings are consistent with a stepped-care approach, whereby in iduals with higher severity may be better suited to more intensive interventions and in iduals with lower severity could commence with less intensive interventions and step-up to intensive interventions.

Effect of discharge opioid on persistent postoperative opioid use: a retrospective cohort study comparing tapentadol with oxycodone

Publisher: Wiley

Date: 19-12-2022

DOI: 10.1111/ANAE.15933

Abstract: Opioid harm can vary by opioid type. This observational study examined the effect of opioid type (oxycodone vs. tapentadol) on rates of persistent postoperative opioid use (‘persistence’). We linked hospital and community pharmacy data for surgical patients who were dispensed discharge opioids between 1 January 2016 and 30 September 2021. Patients were grouped by opioid experience (‘opioid‐naive’ having received no opioids in the 3 months before discharge) and formulation of discharge opioid (immediate release only or modified release ± immediate release). Mixed‐effects logistic regression models predicted persistence (continued use of any opioid at 90 days after discharge), controlling for key persistence risk factors. Of the 122,836 patients, 2.31% opioid‐naive and 27.24% opioid‐experienced patients met the criteria for persistence. For opioid‐naive patients receiving immediate release opioids, there was no significant effect of opioid type. Tapentadol modified release was associated with significantly lower odds of persistence compared with oxycodone modified release, OR (95%CI) 0.81 (0.69–0.94) for opioid‐naive patients and 0.81 (0.71–0.93) for opioid‐experienced patients. Among patients who underwent orthopaedic surgery (n = 19,832), regardless of opioid experience or opioid formulation, the odds of persistence were significantly lower for those who received tapentadol compared with oxycodone. This was one of the largest and most extensive studies of persistent postoperative opioid use, and the first that specifically examined persistence with tapentadol. There appeared to be lower odds of persistence for tapentadol compared with oxycodone among key subgroups, including patients prescribed modified release opioids and those undergoing orthopaedic surgery.

Self-reported risk-taking behavior during matched-frequency sessions of alcohol versus combined alcohol and energy drinks consumption: Does co-ingestion increase risk-taking?

Publisher: Wiley

Date: 04-2015

DOI: 10.1111/ACER.12700

Abstract: Emerging evidence indicates that consumers of alcohol mixed with energy drink (AmED) self-report lower odds of risk-taking after consuming AmED versus alcohol alone. However, these studies have been criticized for failing to control for relative frequency of AmED versus alcohol-only consumption sessions. These studies also do not account for quantity of consumption and general alcohol-related risk-taking propensity. The aims of the present study were to (i) compare rates of risk-taking in AmED versus alcohol sessions among consumers with matched frequency of use and (ii) identify consumption and person characteristics associated with risk-taking behavior in AmED sessions. Data were extracted from 2 Australian community s les and 1 New Zealand community s le of AmED consumers (n = 1,291). One-fifth (21% n = 273) reported matched frequency of AmED and alcohol use. The majority (55%) of matched-frequency participants consumed AmED and alcohol monthly or less. The matched-frequency s le reported significantly lower odds of engaging in 18 of 25 assessed risk behaviors in AmED versus alcohol sessions. Similar rates of engagement were evident across session type for the remaining behaviors, the majority of which were low prevalence (reported by <15%). Regression modeling indicated that risk-taking in AmED sessions was primarily associated with risk-taking in alcohol sessions, with increased average energy drink (ED) intake associated with certain risk behaviors (e.g., being physically hurt, not using contraception, and driving while over the legal alcohol limit). Bivariate analyses from a matched-frequency s le align with past research showing lower odds of risk-taking behavior after AmED versus alcohol consumption for the same in iduals. Multivariate analyses showed that risk-taking in alcohol sessions had the strongest association with risk-taking in AmED sessions. However, hypotheses of increased risk-taking post-AmED consumption were partly supported: Greater ED intake was associated with increased likelihood of specific behaviors, including drink-driving, sexual behavior, and aggressive behaviors in the matched-frequency s le after controlling for alcohol intake and risk-taking in alcohol sessions. These findings highlight the need to consider both personal characteristics and beverage effects in harm reduction strategies for AmED consumers.

Altered resting functional connectivity patterns associated with problematic substance use and substance use disorders during adolescence

Publisher: Elsevier BV

Date: 2021

DOI: 10.1016/J.JAD.2020.10.051

The effect of approach bias modification during alcohol withdrawal treatment on craving, and its relationship to post-treatment alcohol use in a randomised controlled trial

Publisher: Elsevier BV

Date: 10-2022

DOI: 10.1016/J.DRUGALCDEP.2022.109621

Abstract: Approach bias modification (ApBM) for alcohol use disorder helps prevent relapse, yet the psychological mechanisms underlying its efficacy remain unclear. Alcohol craving predicts relapse and appears to be related to the biased processing of alcohol stimuli which is reduced by ApBM. However, there is little research examining whether ApBM reduces alcohol craving. In a randomised controlled trial testing the effect of 4 ApBM sessions (vs. sham training) on post-treatment alcohol use in 300 alcohol withdrawal inpatients, we administered the Alcohol Craving Questionnaire - Short Form - Revised (ACQ-SF-R) pre and post-training and at 2-week, 3, 6 and 12-month follow ups and a cue-induced craving measure pre and post training. Groups did not significantly differ in terms of declines in ACQ-SF-R total scores (p = .712) or cue-induced craving (p = .841) between the first and last training session, nor in terms of ACQ-SF-R scores at follow-ups (p = .509). However, the ACQ-SF-R Expectancy subscale, which assesses craving based on anticipated positive reinforcement from alcohol, was significantly lower in the ApBM group than in controls following training (p = .030), although the group x time interaction for this subscale was non-significant (p = .062). Post-intervention Expectancy scores mediated only a small portion of ApBM's effect on post-discharge alcohol use (14% in intention-to-treat analysis, p = .046 15% in per-protocol analysis, p = .020). ApBM does not appear to have robust, sustained effects on alcohol craving. Reduced craving is unlikely to account for ApBM's relapse prevention effects. However, further research on whether ApBM's effects are related to devaluation of alcohol reward expectancy is warranted. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12617001241325.

Sub-Saharan African migrant youths' help-seeking barriers and facilitators for mental health and substance use problems

Publisher: Springer Science and Business Media LLC

Date: 02-08-2016

DOI: 10.1186/S12888-016-0984-5

Patterns of self-harm methods over time and the association with methods used at repeat episodes of non-fatal self-harm and suicide: A systematic review

Publisher: Elsevier BV

Date: 02-2019

DOI: 10.1016/J.JAD.2018.11.001

Abstract: The risk of self-harm repetition and suicide may be influenced by self-harm method choice. However, there are mixed findings regarding whether there is a discernible pattern in self-harm methods over successive episodes of non-fatal self-harm, and if so, how these may be associated with self-harm repetition and/or suicide. A systematic review of five electronic databases was undertaken until 31 May 2018 to identify cohort studies on patterns of self-harm methods and their association with methods used either at repeat self-harm episodes and/or suicide. 15 studies were included reporting data on of 127,371 participants. Over an average follow-up period of 2.8 years, one-third (33.3%) switched methods between episodes of self-harm, most commonly from self-injury to self-poisoning. For suicide, almost one-half (42.1%) switched methods over an average follow-up period of 11.2 years. Studies were characterised by a moderate study quality. Studies tended to group all methods into self-injury and/or self-poisoning with little consideration as to the erse range of self-harm methods included within these broad categories and the likely differences in potential lethality between these methods. Few investigated the role of alcohol and/or drug dependence and mental illness on self-harm method choice. Given the frequency of method switching observed, and the lack of discernible patterns over time, all patients should be routinely assessed for risk and needs irrespective of the method used at the index episode of non-fatal self-harm.

The role of affective dysregulation in drug addiction

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.CPR.2010.04.005

Abstract: Although affective and substance use disorders frequently co-occur, the role of affective dysregulation in addiction is often overlooked. This paper reviews the role of affective dysregulation in the initiation and maintenance of substance use disorders (SUDs), presenting evidence for a relationship between SUD and three biologically-based dimensions of affective temperament and behaviour: negative affect (NA), positive affect (PA), and effortful control (EC). High NA, low EC, and both high and low PA were each found to play a role in conferring risk and maintaining substance use behaviours, although the strength of their influence differed depending on stage of illness (i.e., early onset use through to addiction). Given these findings, we argue that future research should explicitly consider how changes within affective systems may underlie the development of SUDs. A better understanding of the role of affective dysregulation in addiction will aid in clarifying how risk is conferred, as well as how addictive behaviours are maintained, thereby informing the development of preventative strategies and novel treatments. Future studies should continue to examine the role of high NA in SUDs, and further examine the respective roles of high PA, low PA, and low EC, as well as identifying the affective characteristics that predispose high-risk in iduals to later substance use problems.

Single session web-based counselling: a thematic analysis of content from the perspective of the client

Publisher: Informa UK Limited

Date: 11-09-2014

DOI: 10.1080/03069885.2014.938609

Determining the Impact of Opioid Policy on Substance Use and Mental Health–Related Harms: Protocol for a Data Linkage Study

Publisher: JMIR Publications Inc.

Date: 14-08-2023

DOI: 10.2196/51825

Orbitofrontal Cortex Volume and Effortful Control as Prospective Risk Factors for Substance Use Disorder in Adolescence

Publisher: S. Karger AG

Date: 14-12-2016

DOI: 10.1159/000452159

Abstract: b i Background: /i /b Orbitofrontal cortex (OFC) dysfunction has been proposed to increase the risk for developing a substance use disorder (SUD) during adolescence. In this study, we suggest that a reduction in OFC volumes might underlie temperament-based risk factors for SUD, and examined whether smaller OFC volumes during early adolescence could predict later development of SUD. b i Methods and Materials: /i /b Adolescents (n = 107 58 male, 49 female) underwent structural MRI and completed a self-report measure of temperamental effortful control at age 12. At 3 subsequent assessments (aged 15, 16, and 18) SUD was assessed via a semi-structured clinical interview. By the third assessment, 24 participants (22.4%) had received a lifetime diagnosis of SUD. b i Results: /i /b Smaller volumes of the left OFC, right OFC, and left medial subregions predicted lifetime history of SUD by age 18. Volumes of the left OFC and left lateral subregions were positively correlated with effortful control, and left OFC volumes mediated the relationship between effortful control and SUD. b i Conclusions: /i /b Smaller volumes of the OFC and low effortful control during adolescence appear to be associated phenotypes that increase the risk of subsequent SUD. Further studies examining the temporal sequence of these risk factors are needed to fully understand this relationship.

Awareness of energy drink intake guidelines and associated consumption practices: A cross-sectional study

Publisher: Springer Science and Business Media LLC

Date: 12-2016

DOI: 10.1186/S12889-015-2685-2

Declining drinking among adolescents: Are we seeing a denormalisation of drinking and a normalisation of non‐drinking?

Publisher: Wiley

Date: 14-07-2022

DOI: 10.1111/ADD.15611

Abstract: In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (ages between 12–17 years old). These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population. Hypotheses examining in idual factors fail adequately to provide the necessary ‘big picture’ thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non‐drinking occurring for adolescents in many western countries. Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non‐drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non‐drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi‐dimensional tool for understanding declines in adolescent drinking.

Attentional bias for drug cues in opiate dependence

Publisher: Cambridge University Press (CUP)

Date: 2000

DOI: 10.1017/S0033291799001269

Abstract: Background. In a number of theories of compulsive drug use conditioned responses to stimuli associated with drug taking play a pivotal role. For ex le, according to incentive-sensitization theory (Robinson & Berridge, 1993), drug-related stimuli selectively capture attention, and the neural mechanisms underlying this attentional bias play a key role in the development and maintenance of drug dependence, and in relapse. However, there has been little work that assesses attentional biases in addiction. Methods. We used a pictorial probe detection task to investigate whether there is an attentional bias to stimuli associated with drug use in opiate dependence. Stimuli presented included pairs of drug-related and matched neutral pictures. Methadone-maintained opiate addicts ( N = 16) were compared with age-matched controls ( N = 16). Results. A mixed design analysis of variance of response times to probes revealed a significant three-way interaction of group×drug picture location×probe location. Opiate addicts had relatively faster reaction times to probes that replaced drug pictures rather than neutral pictures, consistent with the predicted attentional bias to drug-related stimuli. Conclusions. These results support the idea that an attentional bias for drug-related stimuli occurs in opiate dependence. This is consistent with the concept of a central role for such salient stimuli in compulsive drug use.

Exploring harms experienced by children aged 7 to 11 using ambulance attendance data: A 6-year comparison with adolescents aged 12–17

Publisher: MDPI AG

Date: 02-07-2018

DOI: 10.3390/IJERPH15071385

Online screening for alcohol and other drug problems: An acceptable method for accessing help

Publisher: AMPCo

Date: 08-2013

DOI: 10.5694/MJA13.10219

Parent and family factors associated with service use by young people with mental health problems: a systematic review

Publisher: Wiley

Date: 12-03-2015

DOI: 10.1111/EIP.12211

Abstract: To conduct a systematic review of parent and family factors associated with service use for young people with mental health problems, to inform early intervention efforts aimed at increasing service use by young people. A systematic search of academic databases was performed. Articles were included in the review if they had: a s le of young people aged between 5 and 18 years service use as the outcome measure one or more parental or family variables as a predictor and a comparison group of non-service using young people with mental health problems. In order to focus on factors additional to need, the mental health symptoms of the young person also had to be controlled for. Stouffer's method of combining P-values was used to draw conclusions as to whether or not associations between variables were reliable. Twenty-eight articles were identified investigating 15 parental or family factors, 7 of which were found to be associated with service use for a young person with mental health needs: parental burden, parent problem perception, parent perception of need, parent psychopathology, single-parent household, change in family structure and being from the dominant ethnic group for the United States specifically. Factors not found to be related to service use were: family history of service use, parent-child relationship quality, family functioning, number of children, parent education level, parent employment status, household income and non-urban location of residence. A number of family-related factors were identified that can inform effective interventions aimed at early intervention for mental health problems. Areas requiring further research were also identified.

“It was terrible. I didn’t set a limit”: Proximal and Distal Prevention Strategies for Reducing the Risk of a Bust in Gambling Venues

Publisher: Springer Science and Business Media LLC

Date: 29-01-2019

DOI: 10.1007/S10899-019-09829-0

Abstract: Although most gamblers set limits on their gambling and stick to them most of the time, there are times when limits are breached (a 'bust'). Little is known about the prevalence, reasons for and strategies to address busts despite associated harms with a single bust. This mixed methods study used an online survey with a s le of electronic gaming machine gamblers. A total of 104 gamblers were recruited from 11 Australian gambling venues and almost half (45%) reported a bust in the past 12 months. The amount of money spent on the bust ranged from $20 to $1500 AUD (M = $446, SD = $402). The presence of a bust was positively associated with the amount of money spent in the past 30 days, and self-reported greater gambling related harms and greater gambling severity. Reasons for busts included both distal (pre-venue) factors (i.e., negative affect, lapse in intentions to set a limit, needing to win money) and proximal (inside venue) factors (i.e., chasing losses, wins or spins, social facilitation and losing money too quickly). Bust-prevention strategies identified by participants were both distal (e.g., avoid gambling altogether, leave cards or cash at home, set a time or money limit) and proximal (e.g., walk away when losing and change the manner of gambling). As busts are relative to a priori limits, gamblers at any level of gambling severity can experience a bust. Repeated busts may be an indicator of loss of control and a progression towards problem gambling. Interventions need to focus on factors that mitigate the risk of a bust (e.g., pre-commitment) and that assist gamblers to stick to their limits all of the time.

Lack of longitudinal changes in cognition in individuals with methamphetamine use disorder during the first 6 weeks after commencing treatment

Publisher: Informa UK Limited

Date: 02-2021

DOI: 10.1080/00952990.2020.1869243

Preoccupation, gambling and the DSM-V

Publisher: Informa UK Limited

Date: 12-2012

DOI: 10.1080/14459795.2012.698296

Neurocognitive and neuroimaging evidence of behavioural dysregulation in human drug addiction: Implications for diagnosis, treatment and prevention

Publisher: Wiley

Date: 2007

DOI: 10.1080/09595230601036978

Abstract: Neuropsychological and neuroimaging studies have generated a wealth of data demonstrating structural and functional brain changes, as well as cognitive deficits in drug addicted populations. Despite this, it is often difficult to make generalisations or conclusive statements about the neuropsychological and neurobiological correlates of chronic drug use given variations in the nature or extent of deficits observed within or across different classes of drugs. In this review, we focus specifically on the evidence for impairments in prefrontally-mediated cognitive functions that underlie behavioural regulation, namely decision making and inhibitory control. We argue that impairments in these specific domains, which are often compounded by an earlier initiation of drug use, polydrug abuse, comorbid psychiatric conditions, previous head injury, and acute withdrawal effects can serve to increase the risk for making decisions that are impulsive, focussed on short-terms gains and lack inhibitory control. We further argue that these impairments of prefrontal functioning may underpin the compulsive and 'loss-of-control' pattern of drug-seeking and drug-taking that is characteristic of drug addiction. Finally, we consider the implications of these findings for diagnosis, treatment and prevention, suggesting that a comprehensive understanding of the nature and extent of these cognitive deficits should form a core part of the conceptualization and focus of effective treatment.

Why is adolescent drinking declining? A systematic review and narrative synthesis

Publisher: Informa UK Limited

Date: 23-09-2019

DOI: 10.1080/16066359.2019.1663831

N-acetylcysteine (NAC) for methamphetamine dependence: A randomised controlled trial

Publisher: Elsevier BV

Date: 08-2021

DOI: 10.1016/J.ECLINM.2021.101005

How Do Nurses Cope with Shift Work? A Qualitative Analysis of Open-Ended Responses from a Survey of Nurses

Publisher: MDPI AG

Date: 10-10-2019

DOI: 10.3390/IJERPH16203821

Abstract: Nurses are frequently required to engage in shift work given the 24/7 nature of modern healthcare provision. Despite the health and wellbeing costs associated with shift work, little is known about the types of coping strategies employed by nurses. It may be important for nurses to adopt strategies to cope with shift work in order to prevent burnout, maintain wellbeing, and ensure high quality care to patients. This paper explores common strategies employed by nurses to cope with shift work. A workforce survey was completed by 449 shift working nurses that were recruited from a major metropolitan health service in Melbourne, Australia. Responses to open-ended questions about coping strategies were analysed using the framework approach to thematic analysis. Four interconnected main themes emerged from the data: (i) health practices, (ii) social and leisure, (iii) cognitive coping strategies, and (iv) work-related coping strategies. Although a range of coping strategies were identified, sleep difficulties often hindered the effective use of coping strategies, potentially exacerbating poor health outcomes. Findings suggest that in addition to improving nurses’ abilities to employ effective coping strategies on an in idual level, workplaces also play an important role in facilitating nurses’ wellbeing.

Neurocognitive impairment in addiction and opportunities for intervention

Publisher: Elsevier BV

Date: 02-2017

DOI: 10.1016/J.COBEHA.2016.10.003

Tobacco, Caffeine, Alcohol and Illicit Substance Use Among Consumers of a National Psychiatric Disability Support Service

Publisher: Springer Science and Business Media LLC

Date: 07-01-2012

DOI: 10.1007/S11469-011-9373-Y

Social Identity Mapping in Addiction Recovery (SIM-AR): extension and application of a visual method

Publisher: Informa UK Limited

Date: 16-01-2019

DOI: 10.1080/16066359.2018.1544623

Prescribed sedative and other psychotropic medication use among clients attending alcohol and other drug treatment

Publisher: Wiley

Date: 09-07-2018

DOI: 10.1111/DAR.12841

Abstract: Prescribed psychotropic medications contribute to overdose mortality among people with alcohol and other drug (AOD) disorders. We report on prescribed psychotropic medication use among AOD treatment service attendees, focusing on sedative drugs. Prospective multi-site naturalistic outcome study in residential and outpatient AOD treatment facilities in Victoria and Western Australia. A convenience s le of 480 people (57% male mean age 36.1) entering treatment were surveyed, of whom 313 (65%) were followed up by telephone interview after a median of 377 days. Participants' prescribed psychotropic medication use was ascertained by self-report at baseline and follow-up. At baseline, 41% of participants reported prescribed sedative medication (benzodiazepine, zopiclone or zolpidem) use within the past month, including prescriptions to treat withdrawal symptoms. At follow-up, the cohort reported a reduced rate of past month prescribed sedative use (23% P 0.99 for change from baseline). At baseline, 40% of participants were prescribed an antidepressant and 13% an antipsychotic medication, which remained similar at follow-up (45% and 13%, respectively). The high level of prescribed sedative drug use reported by people receiving AOD treatment is a serious public health concern given the increasing incidence of drug overdose deaths in Australia.

Patterns in Reduction or Cessation of Drinking in Australia (2001-2013) and Motivation for Change.

Publisher: Oxford University Press (OUP)

Date: 20-10-2019

DOI: 10.1093/ALCALC/AGY072

Abstract: This paper examines: (a) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population and (b) the reasons given for reducing or ceasing drinking in the most recent survey (2013) stratified by sex and age group. Rates of reducing and ceasing drinking increased between 2001 and 2013 in Australia. Young people were more likely to modify drinking due to lifestyle and enjoyment reasons older groups were more likely to report health reasons. These trends contribute to the broader context of declining alcohol consumption in Australia. Data are from five waves of the National Drug Strategy Household Survey (N = 119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking and to predict motivations for reducing or ceasing drinking by sex and age. Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007 and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons and younger people more likely to report lifestyle reasons or enjoyment. Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons suggest that the social position of alcohol in Australia may be shifting, particularly among young people.

A Gambling Just-In-Time Adaptive Intervention (GamblingLess: In-The-Moment): Protocol for a Microrandomized Trial

Publisher: JMIR Publications Inc.

Date: 23-08-2022

DOI: 10.2196/38958

Abstract: The presence of discrete but fluctuating precipitants, in combination with the dynamic nature of gambling episodes, calls for the development of tailored interventions delivered in real time, such as just-in-time adaptive interventions (JITAIs). JITAIs leverage mobile and wireless technologies to address dynamically changing in idual needs by providing the type and amount of support required at the right time and only when needed. They have the added benefit of reaching underserved populations by providing accessible, convenient, and low-burden support. Despite these benefits, few JITAIs targeting gambling behavior are available. This study aims to redress this gap in service provision by developing and evaluating a theoretically informed and evidence-based JITAI for people who want to reduce their gambling. Delivered via a smartphone app, GamblingLess: In-The-Moment provides tailored cognitive-behavioral and third-wave interventions targeting cognitive processes explicated by the relapse prevention model (cravings, self-efficacy, and positive outcome expectancies). It aims to reduce gambling symptom severity (distal outcome) through short-term reductions in the likelihood of gambling episodes (primary proximal outcome) by improving craving intensity, self-efficacy, or expectancies (secondary proximal outcomes). The primary aim is to explore the degree to which the delivery of a tailored intervention at a time of cognitive vulnerability reduces the probability of a subsequent gambling episode. GamblingLess: In-The-Moment interventions are delivered to gamblers who are in a state of receptivity (available for treatment) and report a state of cognitive vulnerability via ecological momentary assessments 3 times a day. The JITAI will tailor the type, timing, and amount of support for in idual needs. Using a microrandomized trial, a form of sequential factorial design, each eligible participant will be randomized to a tailored intervention condition or no intervention control condition at each ecological momentary assessment across a 28-day period. The microrandomized trial will be supplemented by a 6-month within-group follow-up evaluation to explore long-term effects on primary (gambling symptom severity) and secondary (gambling behavior, craving severity, self-efficacy, and expectancies) outcomes and an acceptability evaluation via postintervention surveys, app use and engagement indices, and semistructured interviews. In all, 200 participants will be recruited from Australia and New Zealand. The project was funded in June 2019, with approval from the Deakin University Human Research Ethics Committee (2020-304). Stakeholder user testing revealed high acceptability scores. The trial began on March 29, 2022, and 84 participants have been recruited (as of June 24, 2022). Results are expected to be published mid-2024. GamblingLess: In-The-Moment forms part of a suite of theoretically informed and evidence-based web-based and mobile gambling interventions. This trial will provide important empirical data that can be used to facilitate the JITAI’s optimization to make it a more effective, efficient, and scalable tailored intervention. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000490774 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380757& isClinicalTrial=False PRR1-10.2196/38958

Modifiable parenting factors associated with adolescent alcohol misuse: a systematic review and meta-analysis of longitudinal studies

Publisher: Wiley

Date: 20-03-2017

DOI: 10.1111/ADD.13785

Abstract: Adolescent alcohol misuse is a growing global health concern. Substantial research suggests that parents have an important role in reducing young people's risk for early initiation of alcohol and alcohol-related harms. To facilitate research translation, we conducted a systematic review and meta-analyses of longitudinal studies examining the range of modifiable parenting factors that are associated with adolescent alcohol initiation and levels of later use/misuse. A systematic literature search was conducted in PubMed, PsycINFO and Embase. Studies were included if they (i) used a longitudinal design (ii) were published in English (iii) measured any modifiable parenting factors in adolescence as predictors (iv) assessed any alcohol-related outcome variables in adolescence and/or alcohol-related problems in adulthood and (v) had a follow-up interval of at least 1 year. Parental behaviours were categorized into 12 parenting factors. Stouffer's P analyses were used to determine whether the associations between variables were reliable when there were sufficient studies available, meta-analyses were also conducted to estimate mean effect sizes. Based on 131 studies, three risk factors (parental provision of alcohol, favourable parental attitudes towards alcohol use and parental drinking) and four protective factors (parental monitoring, parent-child relationship quality, parental support and parental involvement) were identified as longitudinal predictors of both alcohol initiation and levels of later alcohol use/misuse, based on their significant results in both Stouffer's P analyses and meta-analyses. The mean effect sizes were mainly small (rs = -0.224 to 0.263). Risk of adolescent alcohol misuse is positively associated with parental provision of alcohol, favourable parental attitudes towards alcohol use and parental drinking. It is negatively associated with parental monitoring, parent-child relationship quality, parental support and parental involvement.

Relationship between measures of impulsivity in opioid-dependent individuals

Publisher: Elsevier BV

Date: 2018

DOI: 10.1016/J.PAID.2017.08.001

Improving alcohol and mental health treatment for lesbian, bisexual and queer women: Identity matters

Publisher: Elsevier BV

Date: 02-2018

DOI: 10.1111/1753-6405.12739

Abstract: Lesbian, bisexual and queer (LBQ) women experience substantial unmet alcohol and mental health treatment needs. This paper explores the way in which sexual identity shapes experience, and needs, in relation to alcohol and mental health treatment, and presents key messages for improving treatment. Twenty-five in-depth interviews were undertaken with same-sex attracted Australian women, aged 19-71. Interview transcripts were analysed thematically. Key messages offered by participants focused on language, disclosure and practitioner training. Variation in sexual identity did not alter treatment expectations or needs however, we noted an important difference with respect to identity salience, with high LBQ identity salience linked with preference for disclosure and acknowledgement of sexual identity in treatment interactions, and low identity salience linked with a preference not to disclose and for sexual identity not to require acknowledgement in treatment. Treatment providers may find it useful to gather information about the centrality of sexual identity to LBQ women as a means of overcoming treatment barriers related to heteronormative conventions and discrimination, language and disclosure. Implications for public health: Treatment providers should adopt more inclusive language, seek information about identity salience and the importance of sexual identity to the current treatment, and regularly pursue LBQ-related professional development upskilling.

Neuroanatomical alterations in people with high and low cannabis dependence

Publisher: SAGE Publications

Date: 12-07-2020

DOI: 10.1177/0004867419859077

Abstract: We aimed to investigate whether severity of cannabis dependence is associated with the neuroanatomy of key brain regions of the stress and reward brain circuits. To examine dependence-specific regional brain alterations, we compared the volumes of regions relevant to reward and stress, between high-dependence cannabis users (CD+, n = 25), low-dependence cannabis users (CD−, n = 20) and controls ( n = 37). Compared to CD− and/or controls, the CD+ group had lower cerebellar white matter and hippoc al volumes, and deflation of the right hippoc us head and tail. These findings provide initial support for neuroadaptations involving stress and reward circuits that are specific to high-dependence cannabis users.

Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder

Publisher: Springer Science and Business Media LLC

Date: 11-2018

DOI: 10.1186/S13063-018-2999-3

Adaptive coping strategies of affected family members of a relative with substance misuse: A qualitative study

Publisher: Wiley

Date: 08-09-2018

DOI: 10.1111/JAN.13405

Abstract: To explore the coping strategies used by affected family members of a relative with substance misuse. Families play an important role in supporting a relative with substance misuse. However, the experience often has an adverse effect on their general well-being, the extent of which depends largely on their coping strategies. An interpretative phenomenological analysis study. Data were collected between January - December 2015. Semistructured, audio-recorded qualitative interviews were conducted with 31 affected family members. Three main themes and related subthemes were abstracted from the data illustrating how participants coped with their relative's substance misuse: (1) Seeking timely access to evidence-based information (2) Enhancing personal coping strategies and (3) Accessing informal and formal support. Greater investment is needed in support services for affected family members, particularly in regional and rural areas. A wide range of accessible evidence-based information and informal and formal support, including telephone and online support, is needed to assist them to cope in this crucial support-giving role. Affected family members need to adopt a flexible set of coping strategies while supporting a relative with substance misuse. Family and friends, alcohol and other drug services, mental health nurses and other clinicians have a critical role providing emotional, instrumental and educational support to affected family members to enhance their adaptive coping strategies.

Response to commentaries: (de)normalization of drinking and its implications for young people, sociality, culture and epidemiology

Publisher: Wiley

Date: 28-02-2022

DOI: 10.1111/ADD.15848

Sustained attention but not effort-based decision-making predicts treatment motivation change in people with methamphetamine dependence

Publisher: Elsevier BV

Date: 12-2018

DOI: 10.1016/J.JSAT.2018.09.007

Abstract: Early treatment motivation is a meaningful predictor of clinical outcomes in the context of meth hetamine dependence (MD). Cognitive deficits associated with MD can have a significant impact on motivational fluctuations during early treatment. We specifically examined if sustained attention and effort-based decision-making predict early treatment motivation change in in iduals with MD. We hypothesised that both variables would be significant predictors of in idual differences in treatment motivation change. We conducted a longitudinal, observational, cohort study on in iduals with MD (N = 72, Age, M = 31.1, SD = 7.3, 29% female). Participants were assessed with cognitive tests of sustained attention (continuous performance test) and effort-based decision-making (effort expenditure for rewards task) within three weeks of entering treatment and rated their treatment motivation at baseline and at follow up six weeks later (n = 50). Multiple regression was used to examine the predictive value of cognitive variables after controlling for nuisance variables. Cognitive measures significantly predicted change in treatment motivation after accounting for nuisance variables, F(5,43) = 2.89, p = .025. Analysis of in idual predictors showed that sustained attention, but not decision-making, was a significant negative predictor of improvement in treatment motivation (β = -0.34, p = .015). Poorer attentional function was associated with limited improvement in motivation during early treatment. These findings help to characterise cognitive predictors of treatment motivation and suggest directions for tailored treatment programs. In iduals entering treatment with attentional deficits may benefit from adjustments to therapy and/or cognitive remediation.

Structural brain correlates of alcohol and cannabis use in recreational users

Publisher: Cambridge University Press (CUP)

Date: 10-2006

DOI: 10.1111/J.1601-5215.2006.00154.X

Abstract: Previous studies on substance-dependent populations have shown that age of first use and duration of use are associated with alterations in regional brain volumes. However, it is not clear whether such alterations are factors that predispose young people to use, and so are also present in recreational users, or are a consequence of chronic exposure to substances and/or comorbid psychopathology. To investigate relationships between key brain structures and parameters of alcohol and cannabis use, in otherwise healthy male recreational users. High-resolution magnetic resonance imaging was used to measure hippoc al, amygdala, whole-brain and intracranial cavity (ICC) volumes in 22 young men with a history of both alcohol and cannabis use. Linear regression analyses with hippoc al, amygdala and whole-brain volumes as the dependent variables and age and ICC as covariates were performed. Findings showed that use of cannabis and alcohol at an earlier age were independently predictive of larger amygdala volumes, whereas longer duration of cannabis use was predictive of smaller hippoc al volumes. Our findings offer preliminary support for a relationship between patterns of substance use and regional brain volumes in recreational users. It is speculative, but possible that this relationship is an evidence of a neurobiological vulnerability to drug-taking behaviour.

Associations between opioid dependence and sweet taste preference

Publisher: Springer Science and Business Media LLC

Date: 02-2021

DOI: 10.1007/S00213-021-05774-2

Proof-of-concept trial of Goal Management Training+ to improve executive functions and treatment outcomes in methamphetamine use disorder

Publisher: Elsevier BV

Date: 05-2023

DOI: 10.1016/J.DRUGALCDEP.2023.109846

Shift-work-play: Understanding the positive and negative experiences of male and female shift workers to inform opportunities for intervention to improve health and wellbeing

Publisher: Australian Nursing and Midwifery Federation

Date: 26-05-2021

DOI: 10.37464/2020.382.181

A tiered model of substance use severity and life complexity

Publisher: SAGE Publications

Date: 10-2016

DOI: 10.1080/08897077.2016.1143907

Abstract: Background: In order to improve long-term outcomes for in iduals with substance use problems, one approach is to adopt a system planning model that considers both addiction severity and life complexities. The tiered approach has been developed and tested to describe systems-level need based on levels of risk and problem severity. Methods: An existing tiered model was modified to accommodate Australian data, incorporating substance use severity and life complexity. The hypothesis was that tiers would reflect differences in well-being amongst help seekers such that an increase in tier would be associated with a reduction in well-being, suggesting the need for more intensive (and integrated) interventions. The model was tested using 2 data sets of screening data, collected from face-to-face alcohol and other drug (AOD) service ( n = 430) and online help ( n = 309) seekers, drawn from a larger s le of 2,766 screens. The screen included demographic information and substance use, mental health, and quality of life measures. Results: There was a significant relationship between well-being and tier ranking, suggesting that the model adequately captured elements of severity and complexity that impact on well-being. There were notable differences between the help-seeking populations with a higher proportion of online respondents allocated to lower tiers and more face-to-face respondents allocated to higher tiers. However, there was an overlap in these populations, with more than half of online respondents classified as higher tiers and one fifth of face-to-face respondents classified as lower tiers. This suggests that the model can be used both to assess unmet need in out-of-treatment groups and demand in the absence of dependence in a subpopulation of the face-to-face treatment population. C onclusions: The tiered model provides a method to understand levels of AOD treatment need and, as part of needs-based planning, may be used to optimize treatment responses and resourcing.

Correspondence

Publisher: SAGE Publications

Date: 08-2007

DOI: 10.1080/00048670701449195

Stigma of mental illness and substance misuse in sub-Saharan African migrants: A qualitative study

Publisher: Wiley

Date: 09-10-2018

DOI: 10.1111/INM.12401

Abstract: Stigma of mental illness and substance misuse can deter help seeking, especially in immigrants who are often reluctant to seek help early for these issues. The aim of the present study was to explore the stigma experience surrounding mental illness and substance misuse, and its implications for improving help seeking, for youths and parents from sub-Saharan African immigrant communities. A qualitative, descriptive design was used. In idual interviews were undertaken with 28 youths, and focus group discussions were held with 41 parents and community leaders in Melbourne, Australia. The findings indicated that public stigma and self-stigma were common and deterred participants' help seeking within sub-Saharan African communities. There was concern about the consequences of disclosure. Personal shame, fear of community rejection, and being labelled a 'lunatic' deterred help seeking. Programmes are needed to address stigma, promote help seeking, and increase mental health knowledge. Mental health nurses and other clinicians in the mental health and alcohol and other drug fields can make an important contribution. Steps are needed to employ more sub-Saharan African immigrant clinicians to help increase help seeking from their communities.

P2Y receptors and kidney function

Publisher: Wiley

Date: 09-08-2012

DOI: 10.1002/WMTS.61

Alteration to hippocampal shape in cannabis users with and without schizophrenia.

Publisher: Elsevier BV

Date: 2013

DOI: 10.1016/J.SCHRES.2012.10.040

Abstract: Abnormalities in hippoc al morphology are characteristic of schizophrenia and have also been reported in chronic cannabis users. There is a paucity of research investigating potential additive effects of cannabis use on brain pathology associated with schizophrenia. In this study, we performed hippoc al shape analysis in cannabis-using and non-using patients with schizophrenia, healthy cannabis users and healthy non-using controls. Hippoc al shape changes were observed in each group relative to controls, with the greatest degree of alterations (i.e., deflations across the hippoc us, and with an anterior predisposition), in cannabis-using schizophrenia patients. These alterations were associated with cannabis use patterns and psychotic symptoms.

Comparing rates and characteristics of ambulance attendances related to extramedical use of pharmaceutical opioids in Australia: a protocol for a retrospective observational study

Publisher: BMJ

Date: 05-2019

DOI: 10.1136/BMJOPEN-2019-029170

Abstract: Extramedical use of, and associated harms with pharmaceutical opioids are common. Analysis of coded ambulance clinical records provides a unique opportunity to examine a national population-level indicator of relative harms. This protocol describes an observational study with three aims: (1) to compare supply adjusted rates of pharmaceutical opioid-related ambulance attendances for buprenorphine, codeine, fentanyl, oxycodone, oxycodone-naloxone, morphine, pethidine, tramadol and tapentadol (2) to compare presentation characteristics for these commonly used pharmaceutical opioids and (3) to describe the context surrounding ambulance presentations related to oxycodone, a widely used opioid with an established abuse liability, and tapentadol, a more recent ‘atypical’ opioid on the Australian market, with fewer studies that have directly examined signals of extramedical use. Trained coders extract data from clinical records for ambulance presentations relating to extramedical use of commonly used pharmaceutical opioids. These data form the basis of a large, national database that captures alcohol-related and drug-related harms. Supply adjusted rates of presentations will be examined using Poisson regression. Multinomial logistic regression will be used to compare severity and other characteristics of attendances relating to different pharmaceutical opioids. Tapentadol-related and oxycodone-related cases will be qualitatively examined to understand the situationally specific contexts of the ambulance attendances outside of the characteristics captured in routinely coded variables. Ethics approval related to analysis of ambulance attendance data was obtained from the Eastern Health Human Research Ethics Committee (E122 08–09), with an amendment specific to the qualitative analysis. Findings will be submitted for peer review in 2019. The understanding of risk profiles in real-world settings is of international public health importance. The analysis and publication of findings from this national dataset of clinical records will provide one of the most nuanced analyses to date of relative harms across nine pharmaceutical opioids over a 6-year period.

Recent trends in heroin and pharmaceutical opioid‐related harms in Victoria, Australia up to 2018

Publisher: Wiley

Date: 02-12-2019

DOI: 10.1111/ADD.14784

Abstract: To characterize the trajectory in the years leading up to 2018 in pharmaceutical opioid and heroin morbidity in Victoria, Australia, and to assess the effect on that trajectory of reformulation of oxycodone to a form that could not be easily snorted or injected. Interrupted time-series analyses of population-level data before versus after reformulation of oxycodone, stratified by sex. Victoria, Australia. The population of Victoria aged 12+ years. Ambulance patient care and emergency department (ED) records were examined using both fixed-code and free-text fields, with each record manually cleaned and checked by trained coders. These were used to derive the output variables providing an index of harm: rates of opioid-related ambulance attendances and ED attendances for pharmaceutical opioids and heroin. The input variable was pre- versus post-oxycodone reformulation. There were 30 045 opioid-related ambulance attendances from January 2012 to October 2018 (54% heroin-related), and 10 113 ED attendances from July 2008 to June 2018 (39% heroin-related). There was an increase in the rate (events per 100 000 people per year) of all opioid ED attendances from 2008 to 2018 [increase = 0.063 95% confidence interval (CI) = 0.049, 0.078]. Pharmaceutical opioid ED attendances decreased from 2014 onwards (slope change = -0.083 95% CI = -0.108, -0.059). Heroin-related ED attendances increased from 2014 to 2018 11 324 heroin-related ambulance attendances and 1980 ED attendances were observed from April 2014 to June 2018, compared with the respective estimates of 8176, and 1661 had the pre-April 2014 trend continued (ambulance slope change = 0.296, 95% CI = 0.104, 0.489 ED slope change = 0.026, 95% CI = 0.005, 0.046). The inflection point of 2014 coincided with the re-formulation of oxycodone. In Victoria, Australia, there appears to have been a trend starting around mid-2014 of increasing heroin-related harm, and a flattening of the increase or a decrease of harms relating to pharmaceutical opioids. These changes may, in part, reflect reformulation of oxycodone to reduce the extent to which it can be injected or snorted.

An argument against the implementation of an ‘overarching universal addiction model’ in alcohol and other drug treatment

Publisher: Wiley

Date: 16-04-2018

DOI: 10.1111/DAR.12704

Addiction, compulsive drug seeking, and the role of frontostriatal mechanisms in regulating inhibitory control

Publisher: Elsevier BV

Date: 11-2010

DOI: 10.1016/J.NEUBIOREV.2010.03.001

Abstract: A principal feature of drug addiction is a reduced ability to regulate control over the desire to procure drugs regardless of the risks involved. Traditional models implicated the neural 'reward' system in providing a neurobiological model of addiction. Newer models however, have expanded on this circuitry to include two separate, but interconnecting systems, the limbic system in the incentive sensitization of drugs, and the prefrontal cortex (PFC) in regulating inhibitory control over drug use. Until the recent developments in neuroimaging and brain stimulation techniques, it has been extremely difficult to assess the involvement of the PFC in addiction. In the current review, we explore the involvement of the frontostriatal circuitry in regulating inhibitory control, and suggest how dysregulation of these circuits could be involved in an increased difficulty in ceasing drug use. Following this, we investigate the recent neuropsychological, neuroimaging and brain stimulation studies that explore the presence of these inhibitory deficits, and frontostriatal dysfunctions, across various different substance groups. Further insight into these deficits could contribute to the development of treatment strategies which target these cognitive impairments, and frontostriatal dysfunction, in reducing drug-seeking behaviors.

What do we know about alcohol mixed with energy drink (AmED) use in Australia? Expanding local evidence

Publisher: The Sax Institute

Date: 2018

DOI: 10.17061/PHRP2831817

Abstract: Despite continued health concerns associated with the practice of consuming alcohol mixed with energy drinks (AmED), few Australian studies have examined the popularity of this combination or attempted to characterise AmED consumers. The purpose of this paper is to replicate two previously used survey approaches to consolidate a national picture of AmED consumption in Australia. The survey approaches used were: an online survey with a convenience s le of New South Wales (NSW), Australia, residents (n = 1931 63.7% female median age 23.0 years) and street intercept surveys in regional and metropolitan entertainment precincts in NSW (n = 1265 58.2% male median age 21.0 years). Analyses explored the rates and frequency of AmED use across both s les, and the sociodemographic and substance use predictors of AmED consumption in the past 12 months. More than 90% of participants in both s les reported alcohol consumption in the past 12 months, with approximately 40% of current drinkers also reporting AmED use in the past 12 months. Three-quarters of participants interviewed in entertainment precincts reported alcohol consumption in the previous 12 hours, with one in six of these also reporting AmED consumption in the past 12 hours. AmED users across both s les were more likely than alcohol-only consumers to be younger and male, and to report riskier substance use practices. Health promotion activities are warranted to promote awareness of energy drink guidelines, and the potential harms of exceeding these guidelines, among alcohol consumers. In addition, health workers should consider enquiring about AmED use as an indicator of risk related to substance use.

Pre-Drinking Behavior of Young Heavy Drinkers

Publisher: Informa UK Limited

Date: 25-05-2016

DOI: 10.3109/10826084.2016.1168443

Abstract: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors. The present study examined a group of adolescents who recently had a "big night out" to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting. Participants (n = 351, aged 16-19) representing the heaviest 20-25% of drinkers in their age group were recruited using nonrandom s ling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer. Almost half the s le pre-drank (n = 149), most commonly at a friend's house. Those aged 18-19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol. This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people.

Electrophysiological evidence of the motivational salience of drug cues in opiate addiction

Publisher: Cambridge University Press (CUP)

Date: 05-02-2007

DOI: 10.1017/S0033291707009932

Abstract: Drug-related stimuli reliably induce craving in experimental paradigms, yet are rarely cited by drug users as major precipitants of relapse. We examined the motivational significance of drug cues in opiate dependence, by exploring their impact on central attentional processes. Fourteen methadone-maintained subjects and 14 matched controls were studied. Subjects performed a novel active visual oddball task, consisting of opiate-related and matched neutral pictures, some of which (the oddballs) included a white cup. Subjects were fitted with a 32-channel electrode cap. The P300 for each stimulus category was identified using temporal principal components analysis. The P300 elicited by opiate stimuli was significantly larger than that elicited by neutral stimuli in the methadone-maintained group but not in the controls. There was also a non-significant trend for the opiate stimuli to elicit larger P300s than the oddball stimuli in the addicted group. These results suggest that drug cues acquire motivational salience and automatically capture attentional resources in opiate addicts, even when engaged in a non-drug-related task. Enhanced P300s to drug cues may provide an important biological marker of crucial psychological mechanisms relevant to addiction.

Sleep disturbance in clients attending a specialist addiction clinic

Publisher: Wiley

Date: 19-08-2021

DOI: 10.1111/AJAD.13212

Abstract: Sleep problems are common among clients attending alcohol and drug services, yet the specific components of sleep disturbed by primary drug of concern (PDOC), and their relationships to affective disorder symptoms are unclear. We examined sleep problems in clients ( n = 32) attending a specialist addiction clinic. Global sleep quality was rated poor by % of participants (particularly disturbances, latency and efficiency components), with significant associations ( p .05) between poor sleep quality and depression ( r = .517), anxiety ( r = .571) and stress ( r = .503). Sleep quality was significantly poorer among those with a nonalcohol PDOC compared with alcohol as PDOC, t (22) = 3.09, p = .005. Poor sleep is almost ubiquitous among clients attending alcohol and drug services. However, components of sleep quality disturbed differ in terms of PDOC, highlighting the need for in idualised sleep interventions.

Social problem solving in carers of young people with a first episode of psychosis

Publisher: Wiley

Date: 23-11-2017

DOI: 10.1111/EIP.12301

MAKINGtheLINK: A school-based health promotion programme to increase help-seeking for cannabis and mental health issues among adolescents

Publisher: Wiley

Date: 27-01-2011

DOI: 10.1111/J.1751-7893.2010.00252.X

Abstract: There is increasing concern regarding the use of cannabis among adolescents, especially given recent evidence highlighting its link with later mental disorders. Encouraging young people with mental health or drug issues to seek professional help is an important early intervention strategy however, adolescents are typically reluctant to do so and instead turn to their peers for help. Peers may not have the skills or knowledge required to assist their friends to access professional help. This paper describes the development and evaluation of MAKINGtheLINK, a school-based health promotion programme that promotes help-seeking behaviour for mental health and cannabis use issues among young people. The MAKINGtheLINK programme was piloted with 182 Year 10 students at a secondary school in Melbourne, Australia. Forty teachers received the MAKINGtheLINK staff professional development session. The delivery of the MAKINGtheLINK programme was found to be both acceptable and feasible within a school setting. Students and teachers described it as a fun, engaging, helpful and important programme. Students reported increased confidence and awareness of how to seek help for themselves or a friend, and teachers indicated increased confidence and awareness of how to assist students to seek help for cannabis use and/or mental health problems. MAKINGtheLINK was successfully implemented within the school curriculum. We believe this is the first school-based programme that specifically focuses on facilitating professional help-seeking for cannabis use and mental health problems among young people, and demonstrates that utilizing peer models for help-seeking is a valuable resource for early intervention initiatives.

Structural MRI Findings in Long-Term Cannabis Users: What Do We Know?

Publisher: Informa UK Limited

Date: 06-2010

DOI: 10.3109/10826084.2010.482443

Abstract: In animal studies, tetrahydrocannabinol (THC) has been found to affect brain morphology, particularly within areas rich in cannabinoid receptors (e.g., hippoc us, cerebral cortex). While cannabis remains the most widely used illicit drug worldwide, there has been limited work investigating its effects on human brain tissue. In this paper, we conducted a systematic review of existing structural magnetic resonance imaging studies to examine whether cannabis use is associated with significant changes in brain anatomy. We identified only 13 structural neuroimaging studies, which were erse in terms of s le characteristics (e.g., age of participants, duration and frequency of use) and methodology (e.g., image analysis). No study found global structural changes in cannabis users, although six studies reported regional alterations. While changes in the hippoc us and parahippoc us were frequently identified, the findings were inconsistent across studies. The available literature also provides some evidence that regional structural changes are associated with cannabis use patterns (particularly cumulative dosage and frequency of use), as well as measures of psychopathology (e.g., measures of depressive and psychotic symptoms). Together, these structural imaging findings suggest that THC exposure does affect brain morphology, especially in medial-temporal regions. Given the small literature available and the limitations of studies to date, further research is clearly required, particularly given the prevalence of cannabis use worldwide.

Treatment of cannabis use among people with psychotic or depressive disorders: A systemic review

Publisher: Physicians Postgraduate Press, Inc

Date: 15-03-2010

DOI: 10.4088/JCP.09R05119GRY

Alprazolam and wider benzodiazepine misuse in Australia - Sources of supply and evidence of harms

Publisher: SAGE Publications

Date: 03-07-2013

DOI: 10.1177/0004867412453774

White matter microstructure in opiate addiction

Publisher: Wiley

Date: 11-11-2010

DOI: 10.1111/J.1369-1600.2010.00266.X

Abstract: Heroin addiction has been associated with impaired neuronal connectivity and cognitive deficits. One mechanism that potentially explains these findings is alterations in white matter connectivity secondary to chronic opiate use. However, few studies have quantitavely examined white matter deficits in opiate addiction (OA). Here, we investigated white matter microstructure in OA using diffusion tensor imaging (DTI). We performed voxel-wise analysis of fractional anisotropy (FA) in 24 participants with OA and 29 healthy controls. The OA group showed reduced FA in multiple pathways including the corpus callosum, thalamic radiation and inferior longitudinal fasciculus. This FA reduction was mainly the result of increased radial diffusivity (λ(⊥)), indicative of myelin pathology. Longer duration of OA was also associated with axonal diffusivity (λ(1)), most robustly in superior longitudinal fasciculi and right frontal white matter suggesting axonal injury in long-term users. Together, the findings indicate that chronic OA use has widespread and erse effects on neuronal connectivity and function.

Comparing opioid types in the persistence of opioid use following surgical admission: a study protocol for a retrospective observational linkage study comparing tapentadol and oxycodone in Australia

Publisher: BMJ

Date: 04-2022

DOI: 10.1136/BMJOPEN-2021-060151

Abstract: Each year, an estimated two million Australians commence opioids, with 50 000 developing longer-term (persistent) opioid use. An estimated 3%–10% of opioid-naïve patients prescribed opioids following surgery develop persistent opioid use. This study will compare rates of persistent opioid use between two commonly used postoperative opioids, oxycodone and tapentadol, to understand if initial postoperative opioid type is important in determining longer-term outcomes. A retrospective data linkage study that analyses administrative data from hospital and community pharmacies. Data will be obtained from at least four pharmacies that service large hospitals with comparable supplies of oxycodone and tapentadol. The study will include at least 6000 patients who have been dispensed a supply of oxycodone or tapentadol to take home following their discharge from a surgical ward. The primary outcome measure will be persistent opioid use at 3 months postdischarge for opioid naïve people who receive either immediate release tapentadol or immediate release oxycodone. Hierarchical logistic regression models will be used to predict persistent opioid use, controlling for covariates including comorbidities. Ethics approval has been obtained through the Monash University Human Research Ethics Committee (29977). We will present project findings in a peer-reviewed journal article, in accordance with the REporting of studies Conducted using Observational Routinely-collected health Data statement.

Primary caregivers' satisfaction with clinicians' response to them as informal carers of young people with first-episode psychosis

Publisher: Wiley

Date: 03-09-2012

DOI: 10.1111/J.1365-2702.2011.03836.X

Abstract: Aim. To explore first‐time primary caregivers’ experience of the way mental health nurses and other mental health clinicians respond to them as carers of young people with first‐episode psychosis. Background. Caregivers have a key role in supporting family members/relatives with mental illness, but their contribution is undervalued frequently by mental health nurses and other mental health clinicians. Design. Qualitative interpretative phenomenological analysis. Method. A qualitative interpretative design was undertaken, using semi‐structured, audio‐recorded interviews. Twenty primary caregivers were recruited through Orygen Youth Health, a first‐episode psychosis centre in Melbourne. Interpretative phenomenological analysis was used to identify themes in the data. Results. Two competing themes were identified in the data, highlighting caregivers’ contrasting experience with mental health nurses and other mental health clinicians. First, most clinical staff were approachable and supportive. Second, several carers felt their contribution was undervalued by some clinical staff. This was as a consequence of being excluded from clinical deliberations because of clinical staffs’ concerns and young people’s requests about maintaining confidentiality regarding treatment, as well as carers feeling their role was not taken seriously by clinical staff. Conclusion. First‐time primary carers have positive and negative experiences with first‐episode psychosis mental health nurses and other clinicians, and these competing events are interrelated. Experiences are affected directly by the manner they are treated by clinical staff and this may, in turn, affect carers’ commitment to caring, the way they engage with clinical staff on subsequent occasions and towards the first‐episode psychosis service generally. Relevance to clinical practice. Greater appreciation is needed of the contribution, experience and difficulties caregivers encounter in their role and in engaging with mental health nurses and other clinicians. Additional training is required for clinical staff in family interventions and to familiarise them with legislation and mental health policies relating to carers.

Comparing rates and characteristics of ambulance attendances related to extramedical use of pharmaceutical opioids in Victoria, Australia from 2013 to 2018

Publisher: Wiley

Date: 13-01-2020

DOI: 10.1111/ADD.14896

Does methamphetamine use increase violent behaviour? Evidence from a prospective longitudinal study

Publisher: Wiley

Date: 16-02-2014

DOI: 10.1111/ADD.12474

Abstract: To determine whether violent behaviour increases during periods of meth hetamine use and whether this is due to meth hetamine-induced psychotic symptoms. A fixed-effects (within-subject) analysis of four non-contiguous 1-month observation periods from a longitudinal prospective cohort study. Sydney and Brisbane, Australia. A total of 278 participants aged 16 years or older who met DSM-IV criteria for meth hetamine dependence on entry to the study but who did not meet DSM-IV criteria for life-time schizophrenia or mania. Violent behaviour was defined as severe hostility in the past month on the Brief Psychiatric Rating Scale (BPRS) (corresponding to assault/damage to property). Days of meth hetamine and other substance use in the past month were assessed using the Opiate Treatment Index. Positive psychotic symptoms in the past month were identified using the BPRS. There was a dose-related increase in violent behaviour when an in idual was using meth hetamine compared with when they were not after adjusting for other substance use and socio-demographics [cf. no use in the past month: 1-15 days of use odds ratio (OR) = 2.8, 95% confidence interval (CI) =1.6-4.9 16+ days of use OR = 9.5, 95% CI = 4.8-19.1]. The odds of violent behaviour were further increased by psychotic symptoms (OR = 2.0, 95% CI = 1.1-3.6), which accounted for 22-30% of violent behaviour related to meth hetamine use. Heavy alcohol consumption also increased the risk of violent behaviour (OR = 3.1, 95% CI = 1.4-7.0) and accounted for 12-18% of the violence risk related to meth hetamine use. There is a dose-related increase in violent behaviour during periods of meth hetamine use that is largely independent of the violence risk associated with psychotic symptoms.

Drugs, mental health and the adolescent brain: Implications for early intervention

Publisher: Wiley

Date: 21-04-2008

DOI: 10.1111/J.1751-7893.2008.00059.X

The effects of inhalant misuse on attentional networks

Publisher: Informa UK Limited

Date: 02-2013

DOI: 10.1080/87565641.2012.745547

Abstract: Inhalant misuse among adolescents is poorly understood from a neuropsychological perspective. This study aimed to identify attentional deficits related to inhalant misuse measured with the Attention Network Test (ANT). We examined three groups: 19 inhalant users, 19 cannabis users, and 18 community controls. There were no group differences on the ANT measures of orienting, alerting, and executive control. However, compared to the cannabis and control groups, inhalant users demonstrated an increased rate of response errors in the absence of any reaction time differences. These differences may reflect a selective deficit in sustained attention or greater impulsivity in the inhalant group.

Towards Accurate Predictions and Causal ‘What-if’ Analyses for Planning and Policy-making: A Case Study in Emergency Medical Services Demand

Publisher: IEEE

Date: 07-2020

DOI: 10.1109/IJCNN48605.2020.9206787

Functional connectivity in brain networks underlying cognitive control in chronic cannabis users

Publisher: Springer Science and Business Media LLC

Date: 25-04-2012

DOI: 10.1038/NPP.2012.39

Alcohol use in the year following approach bias modification during inpatient withdrawal: secondary outcomes from a double‐blind, multi‐site randomized controlled trial

Publisher: Wiley

Date: 13-07-2022

DOI: 10.1111/ADD.15989

Abstract: Approach bias modification (ApBM) targeting alcohol approach bias has been previously shown to reduce likelihood of relapse during the first 2 weeks following inpatient withdrawal treatment (IWT). We tested whether ApBM’s effects endure for a longer period by analysing alcohol use outcomes 3, 6 and 12 months post‐discharge. A double‐blind, sham‐controlled randomized controlled trial. Four IWT units in Melbourne, Australia. Three hundred alcohol IWT patients (173 men, 126 women, 1 non‐binary mean age 43.5 years) were recruited between 4 June 2017 and 14 July 2019. Follow‐up data collection was completed on 22 September 2020. Four ApBM sessions were delivered during IWT. ApBM trained participants ( n = 147) to avoid alcohol and approach non‐alcohol beverage cues. Controls ( n = 153) responded to the same stimuli, but without approach/avoidance training. Date of first lapse was recorded for non‐abstinent participants to determine time to first lapse. Time‐line follow‐back interviews assessed past‐month alcohol consumption at each follow‐up, with participants reporting no alcohol consumption classified as abstinent. In analyses of past‐month abstinence, non‐abstinence was assumed in participants lost to follow‐up. Number of past‐month drinking days, standard drinks and heavy drinking days (five or more standard drinks for women or non‐binary six or more standard drinks for men) were calculated for non‐abstinent participants at each follow‐up. ApBM significantly delayed time to first lapse [ApBM median: 53 days, 95% confidence interval (CI) = 21–61 controls = 12 days, 95% CI = 9–21, P = 0.045]. Past‐month abstinence rates at 3‐, 6‐ and 12‐month follow‐ups were 33/153 (21.6%), 30/153 (19.6%), and 24/153 (15.7%) in controls and 51/147 (34.7%), 30/147 (20.4%) and 29/147 (19.7%) in the ApBM group, respectively. Past‐month abstinence was significantly more likely in ApBM participants than controls at the 3‐month follow‐up [odds ratio (OR) = 1.93, 95% CI = 1.16–3.23, P = 0.012], but not at 6‐ or 12‐month follow‐ups (6‐month OR = 1.05, 95% CI = 0.60–1.95, P = 0.862 12‐month OR = 1.32, 95% CI = 0.73–2.40, P = 0.360). No significant group differences were found for indices of alcohol consumption in non‐abstinent participants. Approach bias modification for alcohol delivered during inpatient withdrawal treatment helps to prevent relapse, increasing rates of abstinence from alcohol for at least 3 months post‐discharge.

Verbal learning and memory in adolescent cannabis users, alcohol users and non-users

Publisher: Springer Science and Business Media LLC

Date: 17-02-2011

DOI: 10.1007/S00213-011-2203-X

Abstract: Long-term heavy cannabis use can result in memory impairment. Adolescent users may be especially vulnerable to the adverse neurocognitive effects of cannabis. In a cross-sectional and prospective neuropsychological study of 181 adolescents aged 16-20 (mean 18.3 years), we compared performance indices from one of the most widely used measures of learning and memory--the Rey Auditory Verbal Learning Test--between cannabis users (n=52 mean 2.4 years of use, 14 days/month, median abstinence 20.3 h), alcohol users (n=67) and non-user controls (n=62) matched for age, education and premorbid intellectual ability (assessed prospectively), and alcohol consumption for cannabis and alcohol users. Cannabis users performed significantly worse than alcohol users and non-users on all performance indices. They recalled significantly fewer words overall (p<0.001), demonstrating impaired learning (p<0.001), retention (p<0.001) and retrieval (p<0.05) (Cohen's d 0.43-0.84). The degree of impairment was associated with the duration, quantity, frequency and age of onset of cannabis use, but was unrelated to alcohol exposure or other drug use. No gender effects were detected and the findings remained after controlling for premorbid intellectual ability. An earlier age of onset of regular cannabis use was associated with worse memory performance after controlling for extent of exposure to cannabis. Despite relatively brief exposure, adolescent cannabis users relative to their age-matched counterparts demonstrated similar memory deficits to those reported in adult long-term heavy users. The results indicate that cannabis adversely affects the developing brain and reinforce concerns regarding the impact of early exposure.

The impact of co-occurring mood and anxiety disorders among substance-abusing youth

Publisher: Elsevier BV

Date: 11-2007

DOI: 10.1016/J.JAD.2007.01.011

Abstract: Co-occurring mood and anxiety disorders are highly prevalent amongst substance-using young adolescents, and have been associated with a range of adverse outcomes. Few studies however have examined the impact of affective disorders in s les of older adolescents and young adults attending youth drug treatment services. One hundred young people (mean age 19.4 years) were recruited from two youth drug treatment services in Melbourne, Australia. A structured interview and questionnaires assessing drug use, psychopathology, risk-taking behaviours and quality of life were administered at a mutually convenient location. Fifty percent of the s le met criteria for at least one current mental health disorder. Excluding in iduals with a current psychotic illness (n=3), 49% met criteria for a current mood or anxiety disorder, with 68% reporting a lifetime history. There were high rates of current Major Depressive Disorder (MDD 27%) and Post-traumatic Stress Disorder (PTSD 26%) within the s le. Participants with these disorders were more likely to have a higher number of comorbid disorders, report more substance-related problems and a poorer quality of life. Cross-sectional design, lack of biological assays. In older adolescence and emerging adulthood, young drug users with comorbid affective disorders have greater mental health and substance use morbidity than those with substance use problems alone. These findings have important clinical implications for the management and rehabilitation of young people with substance use disorders.

Benzodiazepine use and aggressive behaviour: A systematic review

Publisher: SAGE Publications

Date: 02-09-2014

DOI: 10.1177/0004867414548902

Abstract: The relationship between benzodiazepine consumption and subsequent increases in aggressive behaviour in humans is not well understood. The current study aimed to identify, via a systematic review, whether there is an association between benzodiazepine consumption and aggressive responding in adults. A systematic review was conducted and reported in line with the PRISMA statement. English articles within MEDLINE, PsycARTICLES, PsycINFO, Academic Search Complete, and Psychology and Behavioural Sciences Collection databases were searched. Additional studies were identified by searching reference lists of reviewed articles. Only articles that explicitly investigated the relationship between benzodiazepine consumption and subsequent aggressive behaviour, or a lack thereof, in human adults were included. Forty-six studies met the inclusion criteria. It was not possible to conduct a meta-analysis due to the heterogeneity of study design and benzodiazepine type and dose. An association between benzodiazepine use and subsequent aggressive behaviour was found in the majority of the more rigorous studies, although there is a paucity of high-quality research with clinical or forensic populations. Diazepam and alprazolam have received the most attention. Dose-related findings are inconsistent: therapeutic doses may be more likely to be associated with aggressive responding when administered as a once-off, whereas higher doses may be more risky following repeated administration. Trait levels of anxiety and hostility may indicate a vulnerability to the experience of benzodiazepine-related aggression. There appears to be a moderate association between some benzodiazepines and subsequent aggressive behaviour in humans. The circumstances under which aggressive responding may be more likely to follow benzodiazepine use remain unclear, although some evidence suggests dose and/or personality factors may influence this effect.

Electrophysiological evidence that drug cues have greater salience than other affective stimuli in opiate addiction

Publisher: SAGE Publications

Date: 28-02-2008

DOI: 10.1177/0269881107083846

Abstract: Previous research has demonstrated that drug cues are able to capture attentional resources in addicted populations. However, few studies have controlled for the possibility that drug users find all motivationally significant (i.e., affective) stimuli particularly salient. We examined this issue in opiate addiction, by exploring the impact of drug-related and affective stimuli on central attentional processes. Sixteen male heroin addicts (seven on opiate pharmacotherapy and nine recently detoxified subjects) and 12 matched controls were studied. Subjects were fitted with a 32-channel electrode cap and were instructed to passively view a series of neutral, affective and opiate-related images. The P300 elicited by drug-related stimuli was significantly larger than that elicited by affective and neutral stimuli in opiate users but not controls. Baseline ratings of craving were also found to predict the degree of P300 facilitation to the drug-related stimuli in the addicted group. Further, the opiate group demonstrated an absence of the typical enhancement of ERP responses to non-drug affective stimuli. These results suggest that opiate addicts demonstrate greater cortical processing of drug cues than other types of affective stimuli. Further research is required to assess whether addiction is specifically associated with reduced sensitivity to natural rewards, aversive stimuli or affective cues in general.

The influence of sex, temperament, risk-taking and mental health on the emergence of gambling: a longitudinal study of young people

Publisher: Informa UK Limited

Date: 02-01-2015

DOI: 10.1080/14459795.2014.1000356

Clinical and demographic characteristics of people who smoke versus inject crystalline methamphetamine in Australia: Findings from a pharmacotherapy trial

Publisher: Wiley

Date: 06-10-2020

DOI: 10.1111/DAR.13183

Abstract: There has been a rapid increase in smoking crystalline meth hetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use meth hetamine. Participants ( N = 151) were dependent on meth hetamine, aged 18–60 years, enrolled in a pharmacotherapy trial for meth hetamine dependence, and reported either injecting ( n = 54) or smoking ( n = 97) meth hetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking meth hetamine and to compare the clinical characteristics of participants who smoked versus injected. Compared to participants who injected meth hetamine, those who smoked meth hetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked meth hetamine used meth hetamine on more days in the past 4 weeks than participants who injected meth hetamine (26 vs. 19 days, P = 0.001) they did not differ significantly in their severity of meth hetamine dependence, withdrawal, craving or psychiatric symptoms ( P 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = −1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = −1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = −1.1 (0.5), P = 0.022]. Smoking crystalline meth hetamine is associated with a younger less marginalised demographic profile than injecting meth hetamine, but a similarly severe clinical profile.

‘I’ll Just Pay the Rent Next Month’: an Exploratory Study Examining Facilitatory Cognitions Among EGM Problem Gamblers

Publisher: Springer Science and Business Media LLC

Date: 06-2019

DOI: 10.1007/S11469-018-9948-Y

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects

Publisher: Elsevier BV

Date: 08-2017

DOI: 10.1016/J.ADDBEH.2017.02.031

Abstract: Negative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship. Explore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions. A convenience s le of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects. There were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates. AmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels.

Factors influencing mortality among alcohol and drug treatment clients in Victoria, Australia: The role of demographic and substance use characteristics

Publisher: SAGE Publications

Date: 29-05-2013

DOI: 10.1177/0004867413491155

Abstract: Clinical studies consistently identify alcohol- and drug-related treatment populations as more likely to die prematurely compared with an age-matched general population. However, demographic characteristics and primary drug of concern as predictors of mortality risk following treatment have not been adequately explored. This paper examines relationships between substance use, demographic factors and mortality among alcohol and drug treatment clients. A retrospective cohort incorporating 7 years of data was utilised to examine mortality outcomes in the 2 years following treatment among Victorian clients recorded on the Alcohol and Drug Information Service (ADIS) database by linking partial client identifiers with the National Death Index (NDI). A cohort of 18,686 clients engaged in at least one course of treatment over a 12-month period was included. Analysis was of crude and standardised mortality rates across client groups in terms of the presenting drug of concern for treatment and demographic characteristics. A higher risk of premature death was associated with older age, being male, not being employed, living alone, medical and psychiatric comorbidity, recent injecting, and a history of intensive drug treatment access. Alcohol treatment clients had the worst prognosis. After adjustment for client characteristics, alcohol treatment clients experienced a significantly higher rate of death compared with other clients. Findings from these previously unexplored data highlight the need to increase awareness of the range and magnitude of risks associated with harmful alcohol use, and to identify approaches to enhance treatment effectiveness to reduce negative outcomes following treatment for populations at elevated risk of harm.

Trends in gamma-hydroxybutyrate-related harms based on ambulance attendances from 2012 to 2018 in Victoria, Australia

Publisher: Wiley

Date: 22-11-2020

DOI: 10.1111/ADD.14848

Abstract: Although the prevalence of gamma-hydroxybutyrate (GHB) use is relatively low globally, harms related to the drug appear to be increasing. Few existing studies present reliable, representative, population-level data on GHB-related harms. The aim of this study was to investigate trends in acute GHB-related harms within an ambulance database in Australia. Cross-sectional, retrospective analysis of data on all GHB-related ambulance attendances in the state of Victoria, Australia during a 7-year period (January 2012-December 2018) MEASUREMENTS: Presentations were characterized based on patient demographics, transport to hospital, co-occurring substance use (i.e. GHB only, alcohol, meth hetamine, heroin, benzodiazepine and cannabis) and clinical presentation (e.g. symptoms of anxiety, psychosis, depression). There were 5866 GHB-related ambulance attendances between 2012 and 2018, with the prevalence rate increasing from 8.8 per 100 000 population in 2012 to a maximum of 21.7 per 100 000 population in 2017. Meth hetamine [odds ratio (OR) = 6.23, P < 0.001] and benzodiazepine-related (OR = 1.43, P < 0.001) co-occurrences ages between 18-29 (OR = 6.58, P < 0.001) and 30-39 years (OR = 2.02, P < 0.001) and male gender (OR = 1.23, P < 0.001) were significant predictors of GHB-related attendances. There has been a 147% increase in the prevalence of GHB-related ambulance attendances in Victoria, Australia between 2012 and 2019, largely attributable to a growth in the proportions of people using gamma-hydroxybutyrate alone or concurrently with meth hetamine.

Predictors of Flexibility in Social Identity Among People Entering a Therapeutic Community for Substance Abuse

Publisher: Informa UK Limited

Date: 02-01-2015

DOI: 10.1080/07347324.2015.982465

Smartphone App Delivery of a Just-In-Time Adaptive Intervention for Adult Gamblers (Gambling Habit Hacker): Protocol for a Microrandomized Trial

Publisher: JMIR Publications Inc.

Date: 26-07-2022

DOI: 10.2196/38919

Abstract: People with gambling problems frequently report repeated unsuccessful attempts to change their behavior. Although many behavior change techniques are available to in iduals to reduce gambling harm, they can be challenging to implement or maintain. The provision of implementation support tailored for immediate, real-time, in idualized circumstances may improve attempts at behavior change. We aimed to develop and evaluate a Just-In-Time Adaptive Intervention (JITAI) for in iduals who require support to adhere to their gambling limits. JITAI development is based on the principles of the Health Action Process Approach with delivery, in alignment with the principles of self-determination theory. The primary objective was to determine the effect of action- and coping planning compared with no intervention on the goal of subsequently adhering to gambling expenditure limits. Gambling Habit Hacker is delivered as a JITAI providing in-the-moment support for adhering to gambling expenditure limits (primary proximal outcome). Delivered via a smartphone app, this JITAI delivers tailored behavior change techniques related to goal setting, action planning, coping planning, and self-monitoring. The Gambling Habit Hacker app will be evaluated using a 28-day microrandomized trial. Up to 200 in iduals seeking support for their own gambling from Australia and New Zealand will set a gambling expenditure limit (ie, goal). They will then be asked to complete 3 time-based ecological momentary assessments (EMAs) per day over a 28-day period. EMAs will assess real-time adherence to gambling limits, strength of intention to adhere to goals, goal self-efficacy, urge self-efficacy, and being in high-risk situations. On the basis of the responses to each EMA, participants will be randomized to the control (a set of 25 self-enactable strategies containing names only and no implementation information) or intervention (self-enactable strategy implementation information with facilitated action- and coping planning) conditions. This microrandomized trial will be supplemented with a 6-month within-group follow-up that explores the long-term impact of the app on gambling expenditure (primary distal outcome) and a range of secondary outcomes, as well as an evaluation of the acceptability of the JITAI via postintervention surveys, app use and engagement indices, and semistructured interviews. This trial has been approved by the Deakin University Human Research Ethics Committee (2020-304). The intervention has been subject to expert user testing, with high acceptability scores. The results will inform a more nuanced version of the Gambling Habit Hacker app for wider use. Gambling Habit Hacker is part of a suite of interventions for addictive behaviors that deliver implementation support grounded in lived experience. This study may inform the usefulness of delivering implementation intentions in real time and in real-world settings. It potentially offers people with gambling problems new support to set their gambling intentions and adhere to their limits. Australian New Zealand Clinical Trials Registry ACTRN12622000497707 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383568 DERR1-10.2196/38919

A Brief Intervention for Improving Alcohol Literacy and Addressing Harmful Alcohol Use Among Women Attending an Australian Breast Screening Service (Health4her): Protocol for a Hybrid Effectiveness-Implementation Trial (Preprint)

Publisher: JMIR Publications Inc.

Date: 08-12-2022

DOI: 10.2196/PREPRINTS.44867

Abstract: lcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumption. A breast screening service is a novel health care setting for brief alcohol intervention, with the potential for extensive reach. his study aimed to conduct a formative evaluation with breast screening service consumers to understand the need for, and acceptability of, brief alcohol intervention in the breast screening setting and collaboratively design a brief alcohol intervention (Health4Her) to test the effectiveness of Health4Her in improving knowledge of alcohol as a breast cancer risk factor (primary outcome), improving alcohol literacy, and reducing consumption among women attending a breast screening service and to examine the implementation strategy through process evaluation. his was a hybrid type II effectiveness-implementation trial comprising a randomized controlled trial (RCT) alongside a mixed methods program evaluation guided by applicable elements of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and Consolidated Framework for Implementation Research. Formative evaluation comprised a retrospective analysis of alcohol consumption data (n=49,240), a web-based survey (n=391), and focus groups and interviews (n=31) with breast screening service consumers. Women attending routine mammography, drinking at any level, were recruited to the single-site, double-blind RCT (n=558), and completed a baseline assessment before randomization (1:1) to receive Health4Her (alcohol brief intervention + lifestyle information) or control (lifestyle information) via animation on an iPad. Follow-up assessments were performed 4 and 12 weeks after randomization. The process evaluation included evaluation of trial administrative data, participant quantitative (n=497) and qualitative feedback (n=30), and site staff qualitative feedback (n=11). his research was funded in March and May 2019. Data collection for the formative evaluation and trial recruitment occurred between January and April 2020 and February and August 2021, respectively, with finalization of follow-up data collection in December 2021. Quantitative process evaluation data were collected during trial implementation, and collection of participant and staff feedback was finalized in December 2021. Results of the retrospective analysis of alcohol consumption data from breast screening service consumers is anticipated to be published in March 2023 and the results of the RCT to be published in March 2023. his study is anticipated to generate new substantial knowledge on the alcohol consumption and literacy needs of women attending breast screening and the extent to which these can be addressed using a novel, tailored brief alcohol intervention. The study design permits the evaluation of the effectiveness and implementation of Health4Her to predict and facilitate uptake in breast screening services. linicalTrials.gov NCT04715516 t2/show/NCT04715516 R1-10.2196/44867

Health service use by same-sex attracted Australian women for alcohol and mental health issues: a cross-sectional study.

Publisher: Royal College of General Practitioners

Date: 15-05-2018

DOI: 10.3399/BJGPOPEN18X101565

Abstract: Same-sex attracted women (SSAW) have higher rates of alcohol and mental health problems than heterosexual women, but utilisation of and satisfaction with treatment is limited. This study investigated the influences on health service use for alcohol and mental health problems among SSAW. The Gelberg-Andersen behavioural model of health service utilisation was used to generate outcome variables. A convenience s le of 521 community-connected Australian SSAW completed an online survey. Health service use according to sexual identity was compared using χ 2 analysis. Binary logistic regression examined associations between the independent variables with treatment utilisation. Reports of alcohol treatment were very low. Only 41.1% of participants with service need had utilised mental health and alcohol treatment. Bisexual women (adjusted odds ratio [AOR] = 2.76) and those with ‘other’ identities (AOR = 2.38) were more likely to use services than lesbian women. Enablers to service use were having a regular GP (AOR = 3.02) disclosure of sexuality to the GP (AOR = 2.42) lesbian, gay, bisexual and transgender (LGBT) community-connectedness (AOR = 1.11) and intimate partner violence ([IPV] AOR = 2.51). Social support was associated with a reduction in treatment use (AOR = 0.97). Significant access barriers included not feeling ready for help, and previous negative experiences related to sexual identity. Disclosing sexual identity to a regular, trusted GP correlated with improved utilisation of alcohol and mental health treatment for SSAW. The benefits of seeking help for alcohol use, and of accessing LGBT-inclusive GPs to do so, should be promoted to SSAW.

How online counselling can support partners of individuals with problem alcohol or other drug use

Publisher: Elsevier BV

Date: 07-2017

DOI: 10.1016/J.JSAT.2017.04.009

Abstract: Problematic alcohol and other drug (AOD) use impacts partners heavily, with an increased risk of experiencing domestic violence, financial stressors, health problems and relationship challenges. However, partners often do not seek help or support due to a range of barriers (e.g., shame, stigma, practical constraints). Online counselling may facilitate help-seeking by overcoming many of these barriers, however research is needed to explore what motivates partners to contact online counselling services, their experiences and needs, and how partners can be best supported online. One hundred transcripts of partners of in iduals with problem AOD use were s led from a 24-hour national AOD synchronous online chat counselling service. Descriptive content analysis was used to investigate themes related to help-seeking. Three broad themes, with seven sub-themes, were identified: (i) the reason for accessing online counselling (seeking advice, wanting to talk), (ii) discussing help-seeking and coping processes (past resent help-seeking or coping strategies, barriers and facilitators to seeking help and change), and (iii) planning for future assistance (future planning, treatment preferences). Partners wanted to talk about their concerns with a non-judgemental professional. However, the majority of help-seekers wanted advice and assistance in problem-solving, coping and the process of seeking further help. Future studies need to examine the impact of online help-seeking by partners.

Pharmacological interventions for the treatment of disordered and problem gambling

Publisher: Wiley

Date: 22-09-2022

DOI: 10.1002/14651858.CD008936.PUB2

Self-reported sleep disturbance in ambulance attendances for suicidal ideation and attempted suicide between 2012 and 2017

Publisher: Elsevier BV

Date: 03-2020

DOI: 10.1016/J.JAD.2019.11.158

Integrated cognitive behaviour therapy for co-occurring substance misuse and major depression: Lessons from a youth mental health service

Publisher: SAGE Publications

Date: 2009

DOI: 10.1080/10398560902912544

Abstract: Objective: The aim of this paper is to describe a 20-week integrated cognitive behavioural therapy (CBT) program addressing co-occurring substance misuse and major depression in young people. Method: Participants were aged between 15 and 25 years, met DSM-IV criteria for major depressive disorder and had at least weekly illicit drug use and/or weekly alcohol use exceeding the Australian national guidelines on alcohol. Results: Between December 2004 and January 2007, an integrated CBT program was offered to 60 young people with co-occurring depression and substance misuse who presented to a youth-specific mental health service. Young people attended for a median of 10.5 sessions. Conclusions: We describe the components of a 20-week integrated CBT program for young people with co-occurring depression and comorbid substance misuse, as well as the challenges associated with providing such treatment. While integrated treatment approaches are recommended as best practice for this population, further evaluation is necessary to determine their effectiveness within routine clinical settings.

A unified online test battery for cognitive impulsivity reveals relationships with real-world impulsive behaviours

Publisher: Springer Science and Business Media LLC

Date: 27-05-2021

DOI: 10.1038/S41562-021-01127-3

Abstract: Impulsive behaviours are a major contributor to the global burden of disease, but existing measures of cognitive impulsivity have suboptimal reliability and validity. Here, we introduce the Cognitive Impulsivity Suite, comprising three computerized/online tasks using a gamified interface. We conceptualize rapid-response impulsive behaviours (disinhibition) as arising from the failure of three distinct cognitive mechanisms: attentional control, information gathering and monitoring/shifting. We demonstrate the construct and criterion validity of the Cognitive Impulsivity Suite in an online community s le (N = 1,056), show test-retest reliability and between-subjects variability in a face-to-face community s le (N = 63), and replicate the results in a community and clinical s le (N = 578). The results support the theoretical architecture of the attentional control, information gathering and monitoring/shifting constructs. The Cognitive Impulsivity Suite demonstrated incremental criterion validity for prediction of real-world, addiction-related problems and is a promising tool for large-scale research on cognitive impulsivity.

Treating depression in patients with alcohol or drug use disorders: A need for clearer guidelines

Publisher: SAGE Publications

Date: 08-05-2017

DOI: 10.1177/0004867417708611

Exploring Clinician Attitudes to Addiction Recovery in Victoria, Australia

Publisher: Informa UK Limited

Date: 02-10-2014

DOI: 10.1080/07347324.2014.949126

Social identity differentiation predicts commitment to sobriety and wellbeing in residents of therapeutic communities

Publisher: Elsevier BV

Date: 09-2019

DOI: 10.1016/J.SOCSCIMED.2019.112459

Abstract: Therapeutic communities (TC) for alcohol and other drug treatment rely strongly on social factors as agents of recovery an approach known as 'community-as-method'. This study adopted a social identity approach in examining the relative strength of participants' recovery group identity and substance using group identity at admission (T1) and after six months (T2) in a TC. Were to investigate whether identity differentiation - the extent to which respondents see themselves more as belonging to recovery groups than belonging to substance using groups - (a) is related to in iduals' primary substance of concern (i.e., hetamine type stimulants alcohol other drugs), and (b) predicts positive indicators of recovery six months after entering a therapeutic community. Adults (N = 307) entering one of five Australian therapeutic communities (TC) completed measures of identification (user, recovery), commitment to sobriety, psychological distress, and personal wellbeing. Participants' endorsement of the user and recovery identity at T1 and T2 did not differ as a function of primary substance of concern. User identity diminished over the six months while recovery identity remained high, regardless of primary drug category. Identity differentiation measured at T2 accounted for 20-25% variance in commitment to sobriety and wellbeing, after accounting for participant demographics, addiction severity, and T1 identity variables. These findings highlight the importance of the relative strength of recovery over substance use related identities in supporting recovery indicators and the central role of the TC in supporting this trajectory.

Recognition of, and attitudes towards, people with depression and psychosis with/without alcohol and other drug problems: results from a national survey of Australian paramedics

Publisher: BMJ

Date: 12-2018

DOI: 10.1136/BMJOPEN-2018-023860

Abstract: Continuing stigma towards mental health problems means that many in iduals—especially men—will first present in crisis, with emergency services often the first point of call. Given this situation, the aims of this paper were to assess paramedics’ ability to recognise, and their attitudes towards, males with clinically defined depression and psychosis with and without comorbid alcohol and other drug (AOD) problems. A cross-sectional national online survey of 1230 paramedics throughout Australia. The survey was based on four vignettes: depression with suicidal thoughts, depression with suicidal thoughts and comorbid alcohol problems, and psychosis with and without comorbid AOD problems. Just under half of respondents recognised depression, but this decreased markedly to one-fifth when comorbid AOD problems were added to the vignette. In contrast, almost 90% recognised psychosis, but this decreased to just under 60% when comorbid AOD problems were added. Respondents were more likely to hold stigmatising attitudes towards people in the vignettes with depression and psychosis when comorbid AOD problems were present. Respondents endorsed questionnaire items assessing perceived social stigma more strongly than personal stigma. Desire for social distance was greater in vignettes focusing on psychosis with and without comorbid AOD problems than depression with and without comorbid AOD problems. Paramedics need a well-crafted multicomponent response which involves cultural change within their organisations and more education to improve their recognition of, and attitudes towards, clients with mental health and AOD problems. Education should focus on the recognition and care of people with specific mental disorders rather than on mental disorders in general. It is essential that education also focuses on understanding and caring for people with AOD problems. Educational interventions should focus on aligning beliefs about public perceptions with personal beliefs about people with mental disorders and AOD problems.

Predictors of Strategy Engagement for the Prevention and Reduction of Gambling Harm: a Prospective Application of the Theory of Planned Behaviour

Publisher: Springer Science and Business Media LLC

Date: 04-04-2020

DOI: 10.1007/S11469-020-00265-5

How the Internet is Changing Gambling: Findings from an Australian Prevalence Survey

Publisher: Springer Science and Business Media LLC

Date: 11-08-2013

DOI: 10.1007/S10899-013-9404-7

Abstract: Interactive gambling as a regulated activity, coupled with easy accessibility to offshore providers represents a new mode and format of gambling superimposed on traditional land-based opportunities. This paper aimed to investigate the prevalence of gambling among Australian adults and the relationship between various gambling activities and interactive modes of access. A second aim was to compare interactive and non-interactive gamblers in terms of socio-demographic characteristics, attitudes and beliefs about gambling and gambling participation. In a nationally representative telephone survey, 15,006 Australian adults completed measures assessing past 12-month gambling participation and a sub-s le completed questions about interactive gambling and beliefs. The majority of participants (64.3 %) reported gambling at least once, with 8.1 % having gambled online. Interactive gamblers gambled on a greater number of activities overall and more frequently. Interactive gamblers were more likely to be male, younger, have home Internet access, participate in more forms of gambling and have higher gambling expenditure. Almost half of the interactive gamblers preferred land-based gambling although a small proportion also noted a number of disadvantages of interactive gambling. This study shows that the nature of gambling participation is shifting with interactive gambling having a significant and growing impact on overall gambling involvement.

Startle-elicited Event-Related Potentials to Affective Stimuli are Associated with Recent Illicit Opioid use among Patients Receiving Opioid Agonist Treatment

Publisher: SAGE Publications

Date: 31-12-2021

DOI: 10.1177/15500594211070100

Abstract: Opioid use disorder (OUD) has been linked to exaggerated attentional, affective, and arousal responses to opioid-related stimuli, as well as altered responses to other affective (eg, naturally rewarding or aversive) stimuli, particularly blunted responses to pleasant/rewarding stimuli. Both exaggerated responses to drug-related stimuli and reduced response to pleasant stimuli may influence the course of OUD and its treatment, however interpretation of studies thus far is limited by methodological issues. In the present study, we examined subjective ratings, and attenuation of the P3 component of the acoustic startle-evoked event-related potential (as a measure of attention), while viewing neutral, pleasant, unpleasant, and drug-related images. Participants prescribed opioid agonist treatment (OAT) for OUD (n = 82) were compared to a carefully-matched control group (n = 33) and to recently-abstinent participants with OUD (n = 22). Relative to controls, participants prescribed OAT gave higher positive valence ratings of drug images, and blunted valence responses to other affective images, but groups did not differ in terms of arousal ratings or P3 litude. Within the OAT group, linear modeling of associations between frequency of recent illicit opioid use and startle P3 litude found an association between increased recent illicit opioid use and reduced attention to pleasant, relative to unpleasant, images. The latter finding may have implications for interventions targeting cognitive biases in people with substance use disorder. In particular, they suggest that enhancing attention to pleasant stimuli may be as, if not more important, than the typical approach of trying to reduce attentional bias to drug-related stimuli.

Pregabalin misuse-related ambulance attendances in Victoria, 2012-2017: characteristics of patients and attendances.

Publisher: AMPCo

Date: 22-11-2018

DOI: 10.5694/MJA2.12036

Abstract: To compare changes in pregabalin prescribing and misuse-related ambulance attendances to characterise the patients attended by paramedics for pregabalin misuse-related harms to assess the association of pregabalin misuse with use of other sedatives and with suicidal ideation and self-harm to compare the characteristics of pregabalin misuse-related harms in people who misuse pregabalin according to whether or not they also used other sedatives. Retrospective analysis of data on ambulance attendances in Victoria, January 2012 - December 2017, for which pregabalin misuse-related harms were a contributing factor. Rates of pregabalin misuse-related ambulance attendances, pregabalin prescription rates (each 6-monthly) patient characteristics, including age, sex, history of drug misuse or psychiatric problems, concurrent use of other sedatives, and current suicidal ideation and self-harm. There were 1201 pregabalin misuse-related attendances during the study period the rate increased from 0.28 cases per 100 000 population in the first half of 2012 to 3.32 cases per 100 000 in the second half of 2017. The attendance rate was strongly correlated with prescription rates in Australia (r = 0.90 P = 0.001). 593 attendances (49%) were for people with a history that may have contraindicated prescribing pregabalin. Pregabalin was frequently misused with other sedatives (812 attendances, 68%), particularly benzodiazepines (440, 37%) 472 attendances (39%) were associated with suicide attempts. People who misused pregabalin with other sedatives more frequently presented with moderate to severe impairments of consciousness, but the frequency of suicide attempts was similar whether other sedatives were concurrently used or not. Rates of pregabalin misuse-related ambulance attendances in Victoria have increased markedly over the past 6 years. Caution is required when prescribing pregabalin for people taking other sedatives. Limiting the dispensing of this drug may reduce the risks associated with its misuse.

A structured, telephone-delivered intervention to reduce methamphetamine use: study protocol for a parallel-group randomised controlled trial

Publisher: Springer Science and Business Media LLC

Date: 29-03-2023

DOI: 10.1186/S13063-023-07172-9

Abstract: Australia has one of the highest rates of meth hetamine (MA) use in the world however, uptake of in-person psychological treatment remains extremely low due to numerous in idual (e.g. stigma, shame) and structural (e.g. service accessibility, geographical location) barriers to accessing care. Telephone-delivered interventions are ideally placed to overcome many of the known barriers to treatment access and delivery. This randomised controlled trial (RCT) will examine the efficacy of a standalone, structured telephone-delivered intervention to reduce MA problem severity and related harms. This study is a double-blind, parallel-group RCT. We will recruit 196 ± 8 in iduals with mild to moderate MA use disorder from across Australia. After eligibility and baseline assessments, participants will be randomly allocated to receive either the Ready2Change-Meth hetamine (R2C-M) intervention ( n = 98 ± 4 four to six telephone-delivered intervention sessions, R2C-M workbooks and MA information booklet) or control ( n = 98 ± 4 four to six ≤5-min telephone check-ins and MA information booklet including information on accessing further support). Telephone follow-up assessments will occur at 6 weeks and 3, 6 and 12 months post-randomisation. The primary outcome is change in MA problem severity (Drug Use Disorders Identification Test, DUDIT) at 3 months post-randomisation. Secondary outcomes are as follows: MA problem severity (DUDIT) at 6 and 12 months post-randomisation, amount of meth hetamine used, meth hetamine use days, meth hetamine use disorder criteria met, cravings, psychological functioning, psychotic-like experiences, quality of life and other drug use days (at some or all timepoints of 6 weeks and 3, 6 and 12 months post-randomisation). Mixed-methods program evaluation will be performed and cost-effectiveness will be examined. This study will be the first RCT internationally to assess the efficacy of a telephone-delivered intervention for MA use disorder and related harms. The proposed intervention is expected to provide an effective, low-cost, scalable treatment for in iduals otherwise unlikely to seek care, preventing future harms and reducing health service and community costs. ClinicalTrials.gov NCT04713124 . Pre-registered on 19 January 2021.

The personal impacts of having a partner with problematic alcohol or other drug use: descriptions from online counselling sessions

Publisher: Informa UK Limited

Date: 07-09-2018

DOI: 10.1080/16066359.2017.1374375

Assembling a ‘good’ and ‘bad’ night's sleep: A multifactorial proposition

Publisher: Wiley

Date: 27-09-2021

DOI: 10.1002/LIM2.48

Abstract: There is increasing demand for effective sleep health and promotion strategies that are accessible to the general population. Sleep hygiene has traditionally focused on promoting behaviours that facilitate good sleep and avoiding behaviours that interfere with sleep. However, simply following good sleep hygiene practices has proven largely ineffective in clinical s les suffering insomnia, and effectiveness of these recommendations in the general population has also been questioned. One reason for this may be the lack of consideration with respect to interactions between these different factors, as many elements determine a ‘good’ and a ‘bad’ night's sleep. The present paper utilised a mixed methods approach using a combination of framework approach thematic analysis (qualitative) and the number of mentions of different characteristics defining a good and bad night's sleep (quantitative) in participants’ ( N = 282 (157 females), mean age 27 years) accounts of their last good and bad night's sleep, and how (if at all) alcohol or drugs played a role. We found that both good and bad night's sleep were influenced by multiple factors and that often the same factors were implicated in both. A significant number of participants described elements of the sleep episode (e.g., timing pre‐ vs. post‐ midnight, consistency of routine, sleep onset latency, sleep environment), or other behavioural or environmental factors (e.g., alcohol or drug use, mood, food consumed prior to sleep) they perceived were involved in their experience of a good or bad night's sleep. Rather than isolating factors as is typically done in sleep hygiene principles, or viewing these factors as discrete and/or having predictable effects on sleep, it is important to examine how these factors coalesce to shape a good and bad night's sleep.

Neuroanatomical correlates of temperament in early adolescents

Publisher: Elsevier BV

Date: 06-2008

DOI: 10.1097/CHI.0B013E31816BFFCA

Adolescents who seek help for depression report greater lifetime use of alcohol and increased experience of alcohol-related problems

Publisher: SAGE Publications

Date: 19-03-2018

DOI: 10.1177/0004867418763539

GAMBLINGLESS: For LIFE study protocol: A pragmatic randomised trial of an online cognitive-behavioural programme for disordered gambling

Publisher: BMJ

Date: 02-2017

DOI: 10.1136/BMJOPEN-2016-014226

Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use: Current evidence and directions for future research

Publisher: Wiley

Date: 09-2010

DOI: 10.1111/J.1465-3362.2010.00207.X

Abstract: ISSUES AND APPROACH: The high rates of co-occurring depression and substance use, and the negative impact of this on illness course and outcomes have been well established. Despite this, few clinical trials have examined the efficacy of cognitive behaviour therapy (CBT). This paper systematically reviews these clinical trials, with an aim of providing recommendations for how future research can develop a more robust evidence base for the treatment of these common comorbidities. Leading electronic databases, including PubMed (ISI) and PsychINFO (CSA), were searched for peer-reviewed journal articles using CBT for the treatment of co-occurring depression and substance use. Of the 55 articles identified, 12 met inclusion criteria and were included in the review. There is only a limited evidence for the effectiveness of CBT either alone or in combination with antidepressant medication for the treatment of co-occurring depression and substance use. While there is support for the efficacy of CBT over no treatment control conditions, there is little evidence that CBT is more efficacious than other psychotherapies. There is, however, consistent evidence of improvements in both depression and substance use outcomes, regardless of the type of treatment provided and there is growing evidence that that the effects of CBT are durable and increase over time during follow up. Rather than declaring the 'dodo bird verdict' that CBT and all other psychotherapies are equally efficacious, it would be more beneficial to develop more potent forms of CBT by identifying variables that mediate treatment outcomes.

Personalized Approach Bias Modification Smartphone App (“SWIPE”) to Reduce Alcohol Use Among People Drinking at Hazardous or Harmful Levels: Protocol for an Open-Label Feasibility Study

Publisher: JMIR Publications Inc.

Date: 14-08-2020

DOI: 10.2196/21278

Abstract: Alcohol accounts for 5.1% of the global burden of disease and injury, and approximately 1 in 10 people worldwide develop an alcohol use disorder. Approach bias modification (ABM) is a computerized cognitive training intervention in which patients are trained to “avoid” alcohol-related images and “approach” neutral or positive images. ABM has been shown to reduce alcohol relapse rates when delivered in residential settings (eg, withdrawal management or rehabilitation). However, many people who drink at hazardous or harmful levels do not require residential treatment or choose not to access it (eg, owing to its cost, duration, inconvenience, or concerns about privacy). Smartphone app–delivered ABM could offer a free, convenient intervention to reduce cravings and consumption that is accessible regardless of time and place, and during periods when support is most needed. Importantly, an ABM app could also easily be personalized (eg, allowing participants to select personally relevant images as training stimuli) and gamified (eg, by rewarding participants for the speed and accuracy of responses) to encourage engagement and training completion. We aim to test the feasibility and acceptability of “SWIPE,” a gamified, personalized alcohol ABM smartphone app, assess its preliminary effectiveness, and explore in which populations the app shows the strongest indicators of effectiveness. We aim to recruit 500 people who drink alcohol at hazardous or harmful levels (Alcohol Use Disorders Identification Test score≥8) and who wish to reduce their drinking. Recruitment will be conducted through social media and websites. The participants’ intended alcohol use goal (reduction or abstinence), motivation to change their consumption, and confidence to change their consumption will be measured prior to training. Participants will be instructed to download the SWIPE app and complete at least 2 ABM sessions per week for 4 weeks. Recruitment and completion rates will be used to assess feasibility. Four weeks after downloading SWIPE, participants will be asked to rate SWIPE’s functionality, esthetics, and quality to assess acceptability. Alcohol consumption, craving, and dependence will be measured prior to commencing the first session of ABM and 4 weeks later to assess whether these variables change significantly over the course of ABM. We expect to commence recruitment in August 2020 and complete data collection in March 2021. This will be the first study to test the feasibility, acceptability, and preliminary effectiveness of a personalized, gamified ABM intervention smartphone app for hazardous or harmful drinkers. Results will inform further improvements to the app, as well as the design of a statistically powered randomized controlled trial to test its efficacy relative to a control condition. Ultimately, we hope that SWIPE will extend the benefits of ABM to the millions of in iduals who consume alcohol at hazardous levels and wish to reduce their use but cannot or choose not to access treatment. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000638932p www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000638932p PRR1-10.2196/21278

Continuing the conversation: 30 years of motivational interviewing dissemination

Publisher: Wiley

Date: 07-06-2016

DOI: 10.1111/ADD.13414

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support

Publisher: Wiley

Date: 23-01-2020

DOI: 10.1111/DAR.13035

Abstract: People with substance use problems frequently present to mainstream health services with a variety of health issues. However, many medical and allied health-care providers feel under-equipped to respond to this population. We describe the Drug and Alcohol Clinical Advisory Service (DACAS), an established 24/7 telephone-delivered model of addiction specialist consultation, and examine recent call data to identify drug use issues for which health practitioners seek support. Methods of DACAS service provision and call data collection are provided. A retrospective review of routinely collected call data between July 2013 and June 2018 was performed, extracting information on call and caller characteristics, and consultation details. During 2013-2018, DACAS responded to 6565 calls, providing access to specialist alcohol and other drug support for more than 1200 practitioners across Victoria, Tasmania and the Northern Territory annually. Higher rates of service use were found among practitioners located in regional and remote areas, relative to those in metropolitan areas. Opioid agonist treatment was the most common drug class for which practitioners sought consultation (39.5%), followed by other opioids (19.4%). Advice-seeking patterns differed according to caller profession, service setting and location. DACAS is providing a multistate-level response to the challenges of accessing specialist addiction treatment, particularly for opioid agonist treatment and other opioid issues, with demonstrated uptake in regional and remote areas. This telephone-delivered service provides an opportunity to expand access to treatment for opioid use disorder and other substance use problems, particularly in areas with less equitable access to specialist addiction care.

Residual cannabis levels in blood, urine and oral fluid following heavy cannabis use

Publisher: Elsevier BV

Date: 04-2015

DOI: 10.1016/J.FORSCIINT.2015.01.026

Abstract: An understanding of tetrahydrocannabinol (THC) kinetics and residual levels after cannabis use is essential in interpreting toxicology tests in body fluids from live subjects, particularly when used in forensic settings for drug abuse, traffic and interpersonal violence cases. However the current literature is largely based on laboratory studies using controlled cannabis dosages in experienced users, with limited research investigating the kinetics of residual THC concentrations in regular high dose cannabis users. Twenty-one dependent cannabis users were recruited at admission to two residential detoxification units in Melbourne, Australia. After being provided with information about, and consenting to, the study, subjects volunteered to provide once-daily blood, urine and oral fluid (saliva) s les for seven consecutive days following admission, involving cessation and abstinence from all cannabis use. Blood and oral fluid specimens were analysed for THC and urine specimens for the metabolite THC-COOH. In some subjects THC was detectable in blood for at least 7 days and oral fluid specimens were positive for THC up to 78 h after admission to the unit. Urinary THC-COOH concentrations exceeded 1000 ng/mL for some subjects 129 h after last use. The presented blood THC levels are higher and persist longer in some in iduals than previously described, our understanding and interpretation of THC levels in long term heavy cannabis users may need to be reconsidered.

Responsiveness to drug cues and natural rewards in opiate addiction: Associations with later heroin use

Publisher: American Medical Association (AMA)

Date: 02-2009

DOI: 10.1001/ARCHGENPSYCHIATRY.2008.522

Abstract: Although drug cues reliably activate the brain's reward system, studies rarely examine how the processing of drug stimuli compares with natural reinforcers or relates to clinical outcomes. To determine hedonic responses to natural and drug reinforcers in long-term heroin users and to examine the utility of these responses in predicting future heroin use. Prospective design examining experiential, expressive, reflex modulation, and cortical/attentional responses to opiate-related and affective stimuli. The opiate-dependent group was reassessed a median of 6 months after testing to determine their level of heroin use during the intervening period. Community drug and alcohol services and a clinical research facility. Thirty-three opiate-dependent in iduals (mean age, 31.6 years) with stabilized opiate-substitution pharmacotherapy and 19 sex- and age-matched healthy non-drug users (mean age, 30 years). Self-ratings, facial electromyography, startle-elicited postauricular reflex, and event-related potentials combined with measures of heroin use at baseline and follow-up. Relative to the control group, the opiate-dependent group rated pleasant pictures as less arousing and showed increased corrugator activity, less postauricular potentiation, and decreased startle-elicited P300 attenuation while viewing pleasant pictures. The opiate-dependent group rated the drug-related pictures as more pleasant and arousing, and demonstrated greater startle-elicited P300 attenuation while viewing them. Although a startle-elicited P300 litude response to pleasant (relative to drug-related) pictures significantly predicted regular (at least weekly) heroin use at follow-up, subjective valence ratings of pleasant pictures remained the superior predictor of use after controlling for baseline craving and heroin use. Heroin users demonstrated reduced responsiveness to natural reinforcers across a range of psychophysiological measures. Subjective rating of pleasant pictures robustly predicted future heroin use. Our findings highlight the importance of targeting anhedonic symptoms within clinical treatment settings.

Characteristics and harms associated with injecting versus smoking methamphetamine among methamphetamine treatment entrants

Publisher: Wiley

Date: 05-2008

DOI: 10.1080/09595230801919486

Abstract: To compare the characteristics and harms associated with injecting and smoking meth hetamine among meth hetamine treatment entrants. A structured face-to-face interview was used to assess demographics, drug use patterns and harms [physical and mental health, psychological distress, psychotic symptoms, crime and human immunodeficiency virus (HIV) risk behaviour] among 400 meth hetamine treatment entrants in Sydney and Brisbane, Australia. Participants who had injected but not smoked meth hetamine in the month before treatment (n = 195, injectors) were compared to participants who had either: (a) injected and smoked (n = 90, injectors who smoke), or (b) smoked but not injected (n = 73, smokers), during this time. In comparison with injectors, smokers were primarily non-injecting drug users, who were younger, more likely to be female and use ecstasy rather than heroin. After adjusting for these differences smokers were less dependent on meth hetamine than injectors, but they took the drug as often and had similarly high levels of psychological distress, poor physical and mental health, psychotic symptoms, sexual risk behaviour and criminal involvement. Injectors who smoked had a similar demographic and clinical profile to injectors, including comparable levels of needle sharing, but they used meth hetamine more often and had greater criminal involvement. Within this treatment s le, smoking meth hetamine occurred among both long-standing injecting drug users and a comparatively younger group of non-injecting drug users. It was associated with less severe meth hetamine dependence than injecting, but more intense use patterns and similar levels of other harms.

The dark side of sniffing: Paint colour affects intoxication experiences among adolescent inhalant users

Publisher: Wiley

Date: 07-2010

DOI: 10.1111/J.1465-3362.2009.00162.X

Abstract: Inhalant abuse among adolescents is a significant health concern in many countries however, limited research has explored whether the intoxication experience differs between commonly used inhalants. The aim of the present study was to examine how exposure to different types of paints (chrome vs. non-chrome) were experienced by adolescent users. Sixteen adolescent (aged 15-19 years) regular inhalant users completed a semistructured questionnaire enquiring about their inhalant use. Participants were ided into two groups based on paint colour preference [chrome paints (n = 10) and non-chrome paints (n = 6)] and were compared using appropriate statistical tests. Relative to non-chrome users, the chrome-using group were more likely to report deliberately inhaling to experience altered perceptions (such as visual and auditory hallucinations). In addition, a significantly greater proportion of chrome users reported that the perceptual alterations they experienced after sniffing paint differed between paint colours, with chrome colours being associated with more vivid hallucinations. While both chrome and non-chrome users reported a comparable level of pleasure from paint sniffing, chrome paint users were more likely to be motivated by the potential to hallucinate. Our findings suggest that the type of inhalant used is an important consideration that may have relevance to clinical treatment.

Improved rates of treatment success following alcohol and other drug treatment among clients who quit or reduce their tobacco smoking

Publisher: Wiley

Date: 31-08-2021

DOI: 10.1111/DAR.13150

Depressive and anxiety symptomatology in ecstasy users: The relative contribution of genes, trauma, life stress and drug use

Publisher: Springer Science and Business Media LLC

Date: 26-01-2010

DOI: 10.1007/S00213-009-1763-5

Abstract: Previous research has identified elevated rates of depressive and anxiety symptoms amongst ecstasy users however, few studies have examined which factors increase the likelihood of experiencing such symptoms. The current study aimed to determine the relationship between ecstasy use and depressive/anxiety symptomatology after controlling for known environmental and genetic (polymorphism of the serotonin transporter gene) risk factors for depression and anxiety disorders. Participants consisted of a community s le of 184 18-35-year olds who had taken ecstasy at least once in the past 12 months. Participants completed an interview and questionnaires and provided a saliva s le. Mood symptoms were assessed using the Mood and Anxiety Symptom Questionnaire. Timeline methods were used to collect information on lifetime and recent ecstasy use, as well as recent other drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview--Trauma List. Genomic DNA was extracted from participant saliva s les. Neither lifetime nor recent ecstasy use was associated with the severity of current mood symptoms, either alone or in combination with genetic risk factors. Rather, lifetime trauma, recent stressful life events, the frequency of tobacco use and recent polydrug use significantly predicted the severity of depressive and anxiety symptoms. These results highlight the need to consider the role of environmental factors when examining the relationship between ecstasy use and mood symptoms. Whether ecstasy exacerbates such symptoms in vulnerable in iduals requires further investigation using prospective designs.

Working memory predicts methamphetamine hair concentration over the course of treatment: moderating effect of impulsivity and implications for dual-systems model

Publisher: Wiley

Date: 08-11-2019

DOI: 10.1111/ADB.12575

Abstract: High impulsivity and poor executive function are characteristic of meth hetamine use disorder. High arousal in the impulsive system has been proposed to compromise the executive system's regulating ability (i.e. the dual-systems model). While interaction between these variables may partly explain poor treatment outcomes associated with meth hetamine use disorder, previous research has tended to examine each factor separately. We investigated whether high impulsivity (measured with an impulsive choice task) and poor executive function (measured with a working memory task) predict meth hetamine use (determined by hair s le) in the 6 weeks following treatment commencement. We also investigated whether impulsive choice moderates the relationship between working memory and meth hetamine use. One hundred and eight in iduals with meth hetamine use disorder (75 percent male) were tested within 3 weeks of commencing treatment 80 (74 percent) were followed up 6 weeks following baseline testing. Cognitive measures significantly predicted drug use after controlling for nuisance variables. Working memory was a significant predictor, while impulsive choice was not. The interaction model included working memory as a predictor and impulsive choice as a moderator. This model was significant, as was the interaction term. Working memory significantly predicted levels of meth hetamine use in early treatment, and impulsive choice moderated this relationship. Those with working memory deficits are particularly vulnerable to using greater amounts of meth hetamine. As working memory increased meth hetamine use decreased among in iduals with low/medium delay discounting. Pre-treatment cognitive testing may identify patients at high risk, while remediation of working memory function may be a treatment target for reducing meth hetamine use.

Treatment for Family Members of People Experiencing Gambling Problems: Family Members Want Both Gambler-Focused and Family-Focused Options

Publisher: Springer Science and Business Media LLC

Date: 18-11-2019

DOI: 10.1007/S11469-019-00143-9

The association between early cannabis use and psychotic-like experiences in a community adolescent sample

Publisher: Elsevier BV

Date: 07-2009

DOI: 10.1016/J.SCHRES.2009.04.001

Abstract: Cannabis use has been associated with greater risk of developing psychotic-like experiences (PLEs) and psychosis. This paper aims to determine if different levels of cannabis (lifetime, regular, recent) exposure are associated with PLEs and specific PLE subscales among adolescents. Participants consisted of a community s le of 880 adolescents in Melbourne, Australia. Adolescents were administered the positive symptom scale of the Community Assessment of Psychic Experiences (CAPE) and measures of substance use and depression. Lifetime cannabis use and the frequency of cannabis use in the last year (recent use) were associated with PLEs, primarily the experience of auditory and visual hallucinations (perceptual abnormalities). Low levels of recent cannabis use were more strongly associated with PLEs than more frequent use. These findings indicate that different levels of cannabis exposure were differentially associated with PLEs and highlight the need for early detection and treatment strategies for PLEs and cannabis use in adolescents.

Trends in amphetamine‐related harms in Victoria

Publisher: AMPCo

Date: 09-2013

DOI: 10.5694/MJA13.10149

Subtyping based on readiness and confidence: the identification of help-seeking profiles for gamblers accessing web-based counselling

Publisher: Wiley

Date: 16-01-2015

DOI: 10.1111/ADD.12796

Abstract: Problem gamblers are not a homogeneous group and recent data suggest that subtyping can improve treatment outcomes. This study administered three readiness rulers and aimed to identify subtypes of gamblers accessing a national web-based counselling service based on these rulers. Participants were 1204 gamblers (99.4% problem gamblers) who accessed a single session of web-based counselling in Australia. Measures included three readiness rulers (importance, readiness and confidence to resist an urge to gamble), demographics and the Problem Gambling Severity Index (PGSI). Gamblers reported high importance of change [mean = 9.2, standard deviation (SD) = 1.51] and readiness to change (mean = 8.86, SD = 1.84), but lower confidence to resist an urge to gamble (mean = 3.93, SD = 2.44) compared with importance and readiness. The statistical fit indices of a latent class analysis identified a four-class model. Subtype 1 was characterized by a very high readiness to change and very low confidence to resist an urge to gamble (n = 662, 55.0%) and subtype 2 reported high readiness and low confidence (n = 358, 29.7%). Subtype 3 reported moderate ratings on all three rulers (n = 139, 11.6%) and subtype 4 reported high importance of change but low readiness and confidence (n = 45, 3.7%). A multinomial logistic regression indicated that subtypes differed by gender (P < 0.001), age (P = 0.01), gambling activity (P < 0.05), preferred mode of gambling (P < 0.001) and PGSI score (P < 0.001). Problem gamblers in Australia who seek web-based counselling comprise four distinct subgroups based on self-reported levels of readiness to change, confidence to resist the urge to gamble and importance of change.

The influence of opioid dependence on salt consumption and related psychological parameters in mice and humans

Publisher: Elsevier BV

Date: 10-2019

DOI: 10.1016/J.DRUGALCDEP.2019.05.021

Abstract: The consumption of dietary salt (NaCl) is controlled by neuronal pathways that are modulated by endogenous opioid signalling. The latter is disrupted by chronic use of exogenous opioid receptor agonists, such as morphine. Therefore, opioid dependence may influence salt consumption, which we investigated in two complimentary studies in humans and mice. Human study: three groups were recruited: i. In iduals who are currently opioid dependent and receiving opioid substitution treatment (OST) ii. Previously opioid dependent in iduals, who are currently abstinent, and iii. Healthy controls with no history of opioid dependence. Participants tasted solutions containing different salt concentrations and indicated levels of salt 'desire', salt 'liking', and perceptions of 'saltiness'. Mouse study: preference for 0.1 M versus 0.2 M NaCl and overall levels of salt consumption were recorded during and after chronic escalating morphine treatment. Human study: Abstinent participants' 'desire' for and 'liking' of salt was shifted towards more highly concentrated salt solutions relative to control and OST in iduals. Mouse study: Mice increased their total salt consumption during morphine treatment relative to vehicle controls, which persisted for 3 days after cessation of treatment. Preference for 'low' versus 'high' concentrations of salt were unchanged. These findings suggest a possible common mechanistic cross-sensitization to salt that is present in both mice and humans and builds our understanding of how opioid dependence can influence dietary salt consumption. This research may help inform better strategies to improve the diet and overall wellbeing of the growing number of in iduals who develop opioid dependence.

The reliability and validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in first-episode psychosis

Publisher: Elsevier BV

Date: 10-2009

DOI: 10.1016/J.ADDBEH.2009.03.001

Abstract: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a brief, easily administered, valid and reliable screening instrument for all psychoactive substances in drug treatment and primary care settings. This study aims to determine the reliability and validity of the ASSIST for detecting substance use disorders in first-episode psychosis. Participants were 214 first-episode psychosis patients attending the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Australia. Participants were administered the ASSIST, Alcohol Use Disorders Identification Test (AUDIT), the Severity of Dependence Scale (SDS) and the Brief Psychiatric Rating Scale (BPRS). Presence of DSM-IV substance abuse and dependence disorders in the previous 12 months was assessed using the Structured Clinical Interview for DSM-IV (SCID-IV). The ASSIST total substance involvement (TSI) score and specific substance involvement (SSI) scores for cannabis, alcohol and hetamine use demonstrated high levels of internal consistency and acceptable levels of concurrent and discriminative validity. In iduals with cutoff scores of >/=2, 4 and 1 on the ASSIST cannabis, alcohol and hetamine SSI scores were 5 to 6 times more likely to meet the diagnostic criteria for these substance use disorders. The ASSIST is a psychometrically sound measure of cannabis, alcohol and hetamine use disorders in first-episode psychosis.

Co-consumption of alcohol and psychotropic medications in episodes of non-fatal self-poisoning attended by ambulance services in Victoria, Australia: Evidence of potential modification by medical severity

Publisher: Royal College of Psychiatrists

Date: 07-2017

DOI: 10.1192/BJP.211.1.53

Rate my sleep: Examining the information, function, and basis in empirical evidence within sleep applications for mobile devices

Publisher: American Academy of Sleep Medicine (AASM)

Date: 15-11-2017

DOI: 10.5664/JCSM.6814

Effect of long-term cannabis use on axonal fibre connectivity

Publisher: Oxford University Press (OUP)

Date: 04-06-2012

DOI: 10.1093/BRAIN/AWS136

Wellbeing and coping strategies of alcohol and other drug therapeutic community workers: a qualitative study

Publisher: Emerald

Date: 10-09-2018

DOI: 10.1108/TC-08-2017-0024

Abstract: The purpose of this paper is to examine the strategies utilised to facilitate the wellbeing of workers of an alcohol and other drug (AOD) therapeutic community (TC) This paper reports on the findings of a qualitative study that involved in-depth interviews with 11 workers from an Australian AOD TC organisation that provides both a residential TC program and an outreach program. Interviews were analysed using thematic analysis Three main interconnected themes emerged through analysis of the data: the challenges of working in an AOD TC organisation, including vicarious trauma, the isolation and safety of outreach workers and a lack of connection between teams in idual strategies for coping and facilitating wellbeing, such as family, friend and partner support and self-care practices organisational facilitators of worker wellbeing, including staff supervision, employment conditions and the ability to communicate openly about stress. The analysis also revealed cross-cutting themes including the unique challenges and wellbeing support needs of outreach and lived experience workers. Rather than just preventing burnout, AOD TC organisations can also play a role in facilitating worker wellbeing. This paper discusses a number of practical suggestions and indicates that additional strategies targeted at “at risk” teams or groups of workers may be needed alongside organisation-wide strategies. This paper provides a novel and in-depth analysis of strategies to facilitate TC worker wellbeing and has implications for TC staff, managers and researchers.

Managing long-term high-dose prescription opioids in patients with non-cancer pain: The potential role of sublingual buprenorphine

Publisher: The Royal Australian College of General Practitioners

Date: 06-2020

DOI: 10.31128/AJGP-07-19-4994

Incidental radiological findings on brain magnetic resonance imaging in first‐episode psychosis and chronic schizophrenia

Publisher: Wiley

Date: 04-10-2002

DOI: 10.1034/J.1600-0447.2002.02217.X

Abstract: To investigate whether patients with first-episode psychosis or chronic schizophrenia have an increased incidence of magnetic resonance imaging (MRI) brain abnormalities compared with control subjects. Totally 340 clinical MRI reports [Controls (n=98), first-episode psychoses (n=152), chronic schizophrenia (n=90)] were reported by a neuroradiologist blind to diagnosis and subsequently categorized using referral criteria (immediate, urgent, routine or no referral). Thirty percent of all scans were reported by a neuroradiologist as abnormal, but the majority required no referral. Patients with chronic schizophrenia were more likely to have clinically significant abnormal scans than patients with first episode psychosis or control subjects. In four patients the MRI findings led to the discovery of previously unsuspected pathology. Patients with chronic schizophrenia have an increased prevalence of incidental brain abnormalities. A small proportion of patients with chronic schizophrenia and first-episode psychosis benefitted directly from MRI scanning.

Variations in cortical folding patterns are related to individual differences in temperament

Publisher: Elsevier BV

Date: 04-2009

DOI: 10.1016/J.PSCYCHRESNS.2008.06.005

Abstract: There is evidence that anterior cingulate cortex (ACC) function is related to in idual differences in temperament. An important question regards how early such brain-behavior associations emerge. We examined the relationship between cortical folding patterns of the ACC, which are functionally relevant and primarily determined by birth, and in idual differences in four core temperament dimensions (Effortful Control, Negative Affectivity, Surgency, and Affiliation). Magnetic resonance imaging was used to classify 153 (81 male) early adolescents as displaying a leftward asymmetric, rightward asymmetric, or symmetric pattern of ACC folding, as indexed by the incidence and extent of the paracingulate sulcus (PCS). A leftward asymmetric pattern of ACC folding was associated with significantly higher temperamental Effortful Control and lower Negative Affectivity than a rightward asymmetric pattern. Further, this difference was significant only for males. Across males and females, a symmetric pattern was associated with higher temperamental Affiliation than was a rightward asymmetric pattern of ACC folding. These findings suggest that early neurodevelopmental processes contribute to in idual differences in temperament. They also illustrate sexual dimorphisms in the neural underpinnings of temperament.

Cognitive Bias Modification Training During Inpatient Alcohol Detoxification Reduces Early Relapse: A Randomized Controlled Trial

Publisher: Wiley

Date: 04-08-2016

DOI: 10.1111/ACER.13163

Abstract: Relapse is common in alcohol-dependent in iduals and can be triggered by alcohol-related cues in the environment. It has been suggested that these in iduals develop cognitive biases, in which cues automatically capture attention and elicit an approach action tendency that promotes alcohol seeking. The study aim was to examine whether cognitive bias modification (CBM) training targeting approach bias could be delivered during residential alcohol detoxification and improve treatment outcomes. Using a 2-group parallel-block (ratio 1:1) randomized controlled trial with allocation concealed to the outcome assessor, 83 alcohol-dependent inpatients received either 4 sessions of CBM training where participants were implicitly trained to make avoidance movements in response to pictures of alcoholic beverages and approach movements in response to pictures of nonalcoholic beverages, or 4 sessions of sham training (controls) delivered over 4 consecutive days during the 7-day detoxification program. The primary outcome measure was continuous abstinence at 2 weeks postdischarge. Secondary outcomes included time to relapse, frequency and quantity of alcohol consumption, and craving. Outcomes were assessed in a telephonic follow-up interview. Seventy-one (85%) participants were successfully followed up, of whom 61 completed all 4 training sessions. With an intention-to-treat approach, there was a trend for higher abstinence rates in the CBM group relative to controls (69 vs. 47%, p = 0.07) however, a per-protocol analysis revealed significantly higher abstinence rates among participants completing 4 sessions of CBM relative to controls (75 vs. 45%, p = 0.02). Craving score, time to relapse, mean drinking days, and mean standard drinks per drinking day did not differ significantly between the groups. This is the first trial demonstrating the feasibility of CBM delivered during alcohol detoxification and supports earlier research suggesting it may be a useful, low-cost adjunctive treatment to improve treatment outcomes for alcohol-dependent patients.

First-time primary caregivers' experience accessing first-episode psychosis services

Publisher: Wiley

Date: 10-02-2011

DOI: 10.1111/J.1751-7893.2010.00246.X

Abstract: Easy access to first-episode psychosis (FEP) services is critical in reducing the duration of untreated illness. However, primary caregivers can encounter difficulties accessing services on behalf of young people with FEP. This qualitative study describes the lived experience of first time primary caregivers of young adults with FEP, with a focus on examining how they access specialist FEP services. A qualitative study was undertaken using semi-structured, in-depth interviews with 20 caregivers in Melbourne. Most carers were women (85%, n = 17) and parents (85%, n = 17). Nearly all lived in the same households as the young people with FEP (90%, n = 18). The mean duration of their involvement with the FEP service was 14.5 months (standard deviation = 8.9). Three competing themes were identified in the data, reflecting caregivers' polarized experiences accessing FEP services. First, general practitioners were regarded as either a resourceful or an unresourceful means of access to FEP services. Second, caregivers often encountered service-focused and carer-focused barriers when initially accessing services. Third, a combination of acquired knowledge, experience with services and caregiver assertiveness enhanced access on subsequent occasions. This study highlights the important contribution and experience of first-time primary caregivers and the difficulties they face accessing services. The findings suggest access should be influenced more by clinical need and less by caregivers'perseverance. The findings also underline the importance of providing clinical training that acknowledges the needs and contributions of caregivers, as well as interventions that meet the unique challenges faced by first-time caregivers accessing services after the onset of FEP.

Effective suicide prevention: Where is the discussion on alcohol?

Publisher: SAGE Publications

Date: 03-05-2018

DOI: 10.1177/0004867418774415

Differentiating first episode substance induced and primary psychotic disorders with concurrent substance use in young people

Publisher: Elsevier BV

Date: 04-2012

DOI: 10.1016/J.SCHRES.2012.01.022

Abstract: Substance use is common in first-episode psychosis, and complicates the accurate diagnosis and treatment of the disorder. The differentiation of substance-induced psychotic disorders (SIPD) from primary psychotic disorders (PPD) is particularly challenging. This cross-sectional study compares the clinical, substance use and functional characteristics of substance using first episode psychosis patients diagnosed with a SIPD and PPD. Participants were 61 young people (15-24 years) admitted to a psychiatric inpatient service with first episode psychosis, reporting substance use in the past month. Diagnosis was determined using the Psychiatric Research Interview for DSM-IV Substance and Mental disorders (PRISM-IV). Measures of clinical (severity of psychotic symptoms, level of insight, history of trauma), substance use (frequency/quantity, severity) and social and occupational functioning were also administered. The PRISM-IV differentially diagnosed 56% of first episode patients with a SIPD and 44% with a PPD. Those with a SIPD had higher rates of substance use and disorders, higher levels of insight, were more likely to have a forensic and trauma history and had more severe hostility and anxious symptoms than those with a PPD. Logistic regression analysis indicated a family history of psychosis, trauma history and current cannabis dependence were the strongest predictors of a SIPD. Almost 80% of diagnostic predictions of a SIPD were accurate using this model. This clinical profile of SIPD could help to facilitate the accurate diagnosis and treatment of SIPD versus PPD in young people with first episode psychosis admitted to an inpatient psychiatric service.

Composition of social networks to build recovery capital differ across early and stable stages of recovery

Publisher: Informa UK Limited

Date: 27-07-2023

DOI: 10.1080/16066359.2023.2238594

Overcoming alcohol and other drug addiction as a process of social identity transition: the social identity model of recovery (SIMOR)

Publisher: Informa UK Limited

Date: 18-08-2015

DOI: 10.3109/16066359.2015.1075980

Helping someone with problem drinking: Mental health first aid guidelines - a Delphi expert consensus study

Publisher: Springer Science and Business Media LLC

Date: 12-2009

DOI: 10.1186/1471-244X-9-79

Abstract: Alcohol is a leading risk factor for avoidable disease burden. Research suggests that a drinker's social network can play an integral role in addressing hazardous (i.e., high-risk) or problem drinking. Often however, social networks do not have adequate mental health literacy (i.e., knowledge about mental health problems, like problem drinking, or how to treat them). This is a concern as the response that a drinker receives from their social network can have a substantial impact on their willingness to seek help. This paper describes the development of mental health first aid guidelines that inform community members on how to help someone who may have, or may be developing, a drinking problem (i.e., alcohol abuse or dependence). A systematic review of the research and lay literature was conducted to develop a 285-item survey containing strategies on how to help someone who may have, or may be developing, a drinking problem. Two panels of experts (consumers/carers and clinicians) in idually rated survey items, using a Delphi process. Surveys were completed online or via postal mail. Participants were 99 consumers, carers and clinicians with experience or expertise in problem drinking from Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. Items that reached consensus on importance were retained and written into guidelines. The overall response rate across all three rounds was 68.7% (67.6% consumers/carers, 69.2% clinicians), with 184 first aid strategies rated as essential or important by ≥80% of panel members. The endorsed guidelines provide guidance on how to: recognize problem drinking approach someone if there is concern about their drinking support the person to change their drinking respond if they are unwilling to change their drinking facilitate professional help seeking and respond if professional help is refused and manage an alcohol-related medical emergency. The guidelines provide a consensus-based resource for community members seeking to help someone with a drinking problem. Improving community awareness and understanding of how to identify and support someone with a drinking problem may lead to earlier recognition of problem drinking and greater facilitation of professional help seeking.

Interventions for Alcohol and Drug Use Disorders in Young People: 10 Key Evidence-Based Approaches to Inform Service Delivery

Publisher: Springer Science and Business Media LLC

Date: 07-10-2020

DOI: 10.1007/S40429-020-00336-6

Peer mentorship of hospital inpatients with substance use disorders is associated with beneficial outcomes

Publisher: BMJ

Date: 24-01-2021

DOI: 10.1136/EBNURS-2019-103218

'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

Publisher: Wiley

Date: 23-10-2015

DOI: 10.1111/ADD.12742

Abstract: We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol. Street intercept surveys (n = 4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. The response rate was 92.1% more than half the study s le was male (60.2%) and the median age was 23 years (range 18-72). Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subs le of participants was tested for other drug use. Compared with the total s le (0.068%), illicit stimulant consumers (0.080% P = 0.004) and energy drink consumers (0.074% P < 0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P < 0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P < 0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P = 0.198 energy drinks P = 0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours. While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.

Alcohol consumption and body composition in a population-based sample of elderly Australian men

Publisher: Springer Science and Business Media LLC

Date: 29-03-2013

DOI: 10.1007/S40520-013-0026-9

Abstract: Alcohol is calorie dense, and impacts activity, appetite and lipid processing. The aim of this study was to therefore investigate the association between alcohol consumption and components of body composition including bone, fat and lean tissue. Participants were recruited from a randomly selected, population-based s le of 534 men aged 65 years and older enrolled in the Geelong Osteoporosis Study. Alcohol intake was ascertained using a food frequency questionnaire and the s le categorised as non-drinkers or alcohol users who consumed ≤2, 3-4 or ≥5 standard drinks on a usual drinking day. Bone mineral density (BMD), lean body mass and body fat mass were measured using dual energy X-ray absorptiometry overall adiposity (%body fat), central adiposity (%truncal fat) and body mass index (BMI) were calculated. Bone quality was determined by quantitative heel ultrasound (QUS). There were 90 current non-drinkers (16.9 %), 266 (49.8 %) consumed 1-2 drinks/day, 104 (19.5 %) 3-4 drinks/day and 74 (13.8 %) ≥5 drinks/day. Those consuming ≥5 drinks/day had greater BMI (+4.8 %), fat mass index (+20.1 %), waist circumference (+5.0 %), %body fat (+15.2 %) and proportion of trunk fat (+5.3 %) and lower lean mass (-5.0 %) than non-drinkers after adjustment for demographic and lifestyle factors. Furthermore, they were more likely to be obese than non-drinkers according to criteria based on BMI (OR = 2.83, 95 %CI 1.10-7.29) or waist circumference (OR = 3.36, 95 %CI 1.32-8.54). There was an inverse relationship between alcohol consumption and QUS parameters and BMD at the mid forearm site no differences were detected for BMD at other skeletal sites. Higher alcohol intake was associated with greater total and central adiposity and reduced bone quality.

Feasibility and acceptability of approach bias modification during methamphetamine withdrawal and related methamphetamine use outcomes

Publisher: Elsevier BV

Date: 11-2019

DOI: 10.1016/J.JSAT.2019.07.008

Abstract: Approach bias modification (ApBM), a computerised cognitive training task which aims to reduce automatic, impulsive responding to drug-related cues, has been found to reduce alcohol consumption among in iduals seeking treatment for their drinking. However, this approach has not been trialled in patients with meth hetamine use disorder (MUD), where altered impulsivity and reward processing are well-established. As such, this study aimed to examine the feasibility and acceptability of four consecutive days of ApBM training during a residential admission for meth hetamine withdrawal. Abstinence rates were examined 2-weeks and 3-months post-discharge. In terms of uptake, 52 of the 99 eligible patients approached agreed to participate and 47 of these 52 commenced training. Uptake and training completion rates (62%) were lower than those achieved in similar trials of ApBM for residential alcohol withdrawal, suggesting there are challenges to its delivery in this setting. This is likely due to the severity of acute meth hetamine withdrawal syndrome and associated behavioural characteristics. However, participants' ratings of the task and reports of post-session craving suggest acceptability was high. Abstinence rates were 61% at 2 weeks and 54% at 3-months, which compare favourably with the abstinence rates observed in a previous large treatment outcome study. The evidence of acceptability and apparent effectiveness suggest future trials of ApBM with MUD patients are warranted. However, ApBM may be more feasible in certain settings or among particular sub-groups where patients are more clinically stable and therefore more likely to complete the training (e.g., residential rehabilitation, after acute withdrawal has subsided).

The experience of young people with depression: A qualitative study

Publisher: Wiley

Date: 22-08-2012

DOI: 10.1111/J.1365-2850.2011.01783.X

Abstract: People who develop depression experience a maelstrom of emotions as they struggle to understand what is happening to them. While the experience has been comparatively well documented in older adults, much less is known about the depression experience and responses of young people. In this study, we aimed to explore the experience of young people diagnosed with depression. Twenty-six young people were recruited from a youth mental health service. A qualitative interpretative design was used, incorporating semi-structured, audio-recorded interviews. Results provided four overlapping themes, reflecting the young people's difficulties in coming to terms with, and responding in self-protective, harmful and at times life-threatening ways to their depression: (1) struggling to make sense of their situation (2) spiralling down (3) withdrawing and (4) contemplating self-harm or suicide. Study conclusions are that young people faced considerable difficulties coming to terms with, and responding to, depression. Improving young people's understanding of depression and its treatment, reducing community stigma and providing accessible and youth-focused services remain important targets for intervention. It is also important to improve mental health literacy in the community to increase awareness of depression and how mental health professionals, including nurses, respond effectively to the young person.

'High' risk? A systematic review of the acute outcomes of mixing alcohol with energy drinks

Publisher: Wiley

Date: 14-07-2014

DOI: 10.1111/ADD.12622

Abstract: Alcohol mixed with energy drinks (AmED) is a relatively new consumption trend generating increasing concern regarding potential adverse effects. Despite the political and health imperative, there has been no systematic and independent synthesis of the literature to determine whether or not AmED offers additional harms relative to alcohol. The aim of this study was to review the evidence about whether co-consumption of energy drinks and alcohol, relative to alcohol alone, alters: (i) physiological, psychological, cognitive and psychomotor outcomes (ii) hazardous drinking practices and (iii) risk-taking behaviour. Pubmed, PsycInfo and Embase databases were searched until May 2013 for papers outlining descriptive, observational analytical and human experimental studies which compared target outcomes for AmED versus alcohol consumers (between-subjects), or AmED versus alcohol consumption (within-subjects). Odds ratios were calculated for target outcomes following screening, data extraction and quality assessment. Data were extracted from 19 papers. Analyses typically revealed increased odds of self-reported stimulation-based outcomes and decreased odds of sedation-based physiological and psychological outcomes relative to when alcohol was consumed alone, as indicated by rigorous cross-sectional descriptive research. These findings typically have not been reflected in experimental research, due possibly to the low doses administered relative to typical self-reported 'real-life' intake. AmED consumers generally report more hazardous alcohol consumption patterns and greater engagement in risk-taking behaviour than alcohol consumers. While most studies had equivocal findings, two studies showed lower odds of risk-taking behaviour for AmED relative to alcohol drinking sessions but limitations with respect to the outcome measures used restrict conclusions with regard to the behavioural outcomes of AmED use. Mixing alcohol with energy drinks may exert a dual effect, increasing stimulation-based effects and reducing sedation-based outcomes the clinical severity and dose threshold has not been established. At this stage it is unclear whether these changes in the nature of intoxication translate into greater alcohol intake and risk-taking behaviour.

Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: A qualitative study

Publisher: Elsevier BV

Date: 10-2018

DOI: 10.1016/J.JSAT.2018.07.005

Abstract: To identify affected family members' (AFMs) experiences of barriers and facilitators to informal and formal help-seeking for themselves and on behalf of a close relative with alcohol and other drug (AOD) misuse. Qualitative study, informed by interpretative phenomenological analysis. Semi-structured, audio-recorded, telephone interviews were used to collect data from 31 AFMs. AFMs experienced several overlapping and at times competing help-seeking obstacles and enablers in accessing informal and formal support for themselves and on behalf of their relative with AOD misuse, and these are reflected in two themes and associated sub-themes: barriers to help-seeking and facilitators to help-seeking. Five help-seeking barriers were abstracted from the data: Stigma discourages help-seeking, Difficulty locating informal and formal support services, Previous negative AOD service help-seeking experiences deter subsequent help-seeking, Hopelessness inhibits help-seeking, and Feeling undervalued as an AFM. Three help-seeking facilitators were abstracted from the data: Previous positive help-seeking experiences increase future help-seeking, Overcoming shame and isolation and being open with trusted significant others, and Persevering in help-seeking. AFMs who access informal and formal help sources for themselves, and on behalf of their relative, are more likely to sustain their important support-giving role. Measures to strengthen AFMs' capacity and willingness to support their relative should be founded on an understanding of factors that affect their own help-seeking in addition to those encountered when help-seeking on behalf of their relative. Our findings have implications for the visibility of AOD services and informal support groups on the Internet, organisational culture of some AOD services, valuing the contributions of AFMs, and protecting AFMs and their relatives' privacy. Our findings also have implications for reducing public stigma of AOD misuse, changing some AFMs' scepticism about treatment outcomes, and reinforcing and enhancing AFMs' skills in persevering with help-seeking.

The impacts of problem gambling on concerned significant others accessing web-based counselling

Publisher: Elsevier BV

Date: 08-2014

DOI: 10.1016/J.ADDBEH.2014.04.011

Abstract: The 'concerned significant others' (CSOs) of people with problem gambling frequently seek professional support. However, there is surprisingly little research investigating the characteristics or help-seeking behaviour of these CSOs, particularly for web-based counselling. The aims of this study were to describe the characteristics of CSOs accessing the web-based counselling service (real time chat) offered by the Australian national gambling web-based counselling site, explore the most commonly reported CSO impacts using a new brief scale (the Problem Gambling Significant Other Impact Scale: PG-SOIS), and identify the factors associated with different types of CSO impact. The s le comprised all 366 CSOs accessing the service over a 21 month period. The findings revealed that the CSOs were most often the intimate partners of problem gamblers and that they were most often females aged under 30 years. All CSOs displayed a similar profile of impact, with emotional distress (97.5%) and impacts on the relationship (95.9%) reported to be the most commonly endorsed impacts, followed by impacts on social life (92.1%) and finances (91.3%). Impacts on employment (83.6%) and physical health (77.3%) were the least commonly endorsed. There were few significant differences in impacts between family members (children, partners, parents, and siblings), but friends consistently reported the lowest impact scores. Only prior counselling experience and Asian cultural background were consistently associated with higher CSO impacts. The findings can serve to inform the development of web-based interventions specifically designed for the CSOs of problem gamblers.

Evaluating the impact of community‐based treatment options on methamphetamine use: findings from the Methamphetamine Treatment Evaluation Study (MATES<

Publisher: Wiley

Date: 12-07-2012

DOI: 10.1111/J.1360-0443.2012.03933.X

Abstract: To evaluate the impact of community-based drug treatment on meth hetamine use using inverse probability of treatment-weighted (IPTW) estimators to derive treatment effects. A longitudinal prospective cohort study with follow-ups at 3 months, 1 year and 3 years. Treatment effects were derived by comparing groups at follow-up. IPTW estimators were used to adjust for pre-treatment differences between groups. Sydney and Brisbane, Australia. Participants were meth hetamine users entering community-based detoxification (n = 112) or residential rehabilitation (n = 248) services and a quasi-control group of meth hetamine users (n = 101) recruited from the community. Frequency of meth hetamine use between interviews (no use, less than weekly, 1-2 days per week, 3+ days per week), continuous abstinence from meth hetamine use, past month meth hetamine use and meth hetamine dependence. Detoxification did not reduce meth hetamine use at any follow-up relative to the quasi-control group. Relative to quasi-control and detoxification groups combined, residential rehabilitation produced large reductions in the frequency of meth hetamine use at 3 months [odds ratio (OR) = 0.23, 95% confidence interval (CI) 0.15-0.36, P < 0.001), with a marked attenuation of this effect at 1 year (OR 0.62, 95% CI 0.40-0.97, P = 0.038) and 3 years (OR = 0.71, 95% CI 0.42-1.19, P = 0.189). The greatest impact was for abstinence: for every 100 residential rehabilitation clients there was a gain of 33 being continuously abstinent at 3 months, with this falling to 14 at 1 year and 6 at 3 years. Community-based residential rehabilitation may produce a time-limited decrease in meth hetamine use, while detoxification alone does not appear to do so.

Time‐dependent neuronal changes associated with craving in opioid dependence: an fMRI study

Publisher: Wiley

Date: 22-09-2017

DOI: 10.1111/ADB.12554

Heavy stimulant use remains a significant health concern for Australia

Publisher: AMPCo

Date: 11-2011

DOI: 10.5694/MJA11.11197

Maintaining and losing control during internet gambling: A qualitative study of gamblers’ experiences

Publisher: SAGE Publications

Date: 27-01-2014

DOI: 10.1177/1461444814521140

Abstract: This paper provides an in-depth exploration of the psychosocial factors and processes related to maintaining and losing control during internet gambling. It explores features of internet gambling leading to loss of control, control strategies used by internet gamblers, and the perceived utility of online responsible gambling measures. Interviews with 25 moderate risk and problem internet gamblers yielded rich first-person accounts analysed using interpretative phenomenological analysis. The most frequently identified aspects of internet gambling leading to impaired control were use of digital money, access to credit, lack of scrutiny and ready accessibility. Participants used a range of self-limiting strategies with variable success. Most considered that more comprehensive responsible gambling measures are required of internet gambling operators. The findings provide insights into the cognitive and behavioural processes that moderate problem gambling and are highly relevant in developing effective prevention and treatment programs for this new interactive mode of gambling.

Isolation of retinoic acid-repressed genes from P19 embryonal carcinoma cells

Publisher: Elsevier BV

Date: 09-1996

DOI: 10.1016/0378-1119(96)00391-5

Abstract: Retinoic acid (RA) plays a critical role in normal development, growth and differentiation by modulating the expression of target genes. Using substractive hybridization cloning, we isolated two cDNAs, whose corresponding mRNAs are repressed upon RA treatment of P19 embryonal carcinoma (EC) cells. The cDNAs correspond to the serine hydroxymethyltransferase (shmt) gene and the early transposon, ETnMG1. RA appears to reduce the stability of ETnMG1 transcript. We also report the sequence of two different isoforms of mouse SHMT. Since SHMT activity is increased when cells are stimulated to proliferate and during the S phase of the cell cycle, we suggest that repression of shmt expression is an important step in RA-induced cell growth arrest and differentiation.

Regional brain abnormalities associated with long-term heavy cannabis use

Publisher: American Medical Association (AMA)

Date: 02-06-2008

DOI: 10.1001/ARCHPSYC.65.6.694

Abstract: Cannabis is the most widely used illicit drug in the developed world. Despite this, there is a paucity of research examining its long-term effect on the human brain. To determine whether long-term heavy cannabis use is associated with gross anatomical abnormalities in 2 cannabinoid receptor-rich regions of the brain, the hippoc us and the amygdala. Cross-sectional design using high-resolution (3-T) structural magnetic resonance imaging. Participants were recruited from the general community and underwent imaging at a hospital research facility. Fifteen carefully selected long-term (>10 years) and heavy (>5 joints daily) cannabis-using men (mean age, 39.8 years mean duration of regular use, 19.7 years) with no history of polydrug abuse or neurologic/mental disorder and 16 matched nonusing control subjects (mean age, 36.4 years). Volumetric measures of the hippoc us and the amygdala combined with measures of cannabis use. Subthreshold psychotic symptoms and verbal learning ability were also measured. Cannabis users had bilaterally reduced hippoc al and amygdala volumes (P = .001), with a relatively (and significantly [P = .02]) greater magnitude of reduction in the former (12.0% vs 7.1%). Left hemisphere hippoc al volume was inversely associated with cumulative exposure to cannabis during the previous 10 years (P = .01) and subthreshold positive psychotic symptoms (P < .001). Positive symptom scores were also associated with cumulative exposure to cannabis (P = .048). Although cannabis users performed significantly worse than controls on verbal learning (P < .001), this did not correlate with regional brain volumes in either group. These results provide new evidence of exposure-related structural abnormalities in the hippoc us and amygdala in long-term heavy cannabis users and corroborate similar findings in the animal literature. These findings indicate that heavy daily cannabis use across protracted periods exerts harmful effects on brain tissue and mental health.

White-matter abnormalities in adolescents with long-term inhalant and cannabis use: a diffusion magnetic resonance imaging study

Publisher: CMA Joule Inc.

Date: 11-2010

DOI: 10.1503/JPN.090177

Views of young people with depression about family and significant other support: Interpretative phenomenological analysis study

Publisher: Wiley

Date: 22-05-2012

DOI: 10.1111/J.1447-0349.2012.00812.X

Addiction, a condition of compulsive behaviour? Neuroimaging and neuropsychological evidence of inhibitory dysregulation

Publisher: Wiley

Date: 25-08-2004

DOI: 10.1111/J.1360-0443.2004.00808.X

Abstract: Addiction has been conceptualized as a shift from controlled experimentation to uncontrolled, compulsive patterns of use. Current neurobiological models of addiction emphasize changes within the brain's reward system, such that drugs of abuse 'hijack' this system and bias behaviour towards further drug use. While this model explains the involuntary nature of craving and the motivational drive to continue drug use, it does not explain fully why some addicted in iduals are unable to control their drug use when faced with potentially disastrous consequences. In this review, we argue that such maladaptive and uncontrolled behaviour is underpinned by a failure of the brain's inhibitory control mechanisms. Relevant neuroimaging, neuropsychological and clinical studies are reviewed, along with data from our own research. The current literature suggests that in addition to the brain's reward system, two frontal cortical regions (anterior cingulate and orbitofrontal cortices), critical in inhibitory control over reward-related behaviour, are dysfunctional in addicted in iduals. These same regions have been implicated in other compulsive conditions characterized by deficits in inhibitory control over maladaptive behaviours, such as obsessive-compulsive disorder. We propose that in chronically addicted in iduals, maladaptive behaviours and high relapse rates may be better conceptualized as being 'compulsive' in nature as a result of dysfunction within inhibitory brain circuitry, particularly during symptomatic states. This model may help to explain why some addicts lose control over their drug use, and engage in repetitive self-destructive patterns of drug-seeking and drug-taking that takes place at the expense of other important activities. This model may also have clinical utility, as it allows for the adoption of treatments effective in other disorders of inhibitory dysregulation.

Examining trends in the representation of young people and alcohol in Australian newspapers over twenty years (2000–2019)

Publisher: Elsevier BV

Date: 2022

DOI: 10.1016/J.DRUGPO.2021.103461

Abstract: The news media can reflect and influence public opinion, as well as affect in idual practice. In the context of significant changes in alcohol consumption among young people over the past twenty years, we examined Australian newspaper reporting of young people (under 18 years) and alcohol to assess whether there have been changes over time in the content and slant of articles that reflect or elucidate these trends. Factiva was used to search newspaper articles from major Australian newspapers over a twenty year period (2000-2019). After screening, two researchers coded 2415 newspaper articles across four key domains: article type, article theme, sources cited and topic slant (e.g. approving, disapproving tone). Change over time across the study period was assessed using joinpoint Poisson regression analyses. There was a significant increase in articles on young people and alcohol between 2000 and 2008, before a corresponding decrease to 2019. Policy or prevention strategies were the most common theme of articles (35.8%), followed by articles reporting on risks or harms associated with alcohol use for young people (18.1%). Researchers were the most common source reported (25.1%), followed by politicians (19.0%). Three quarters of articles (75.9%) had a socially disapproving topic slant, which increased significantly up until 2011, with a corresponding decrease thereafter. Attention to, and problematisation of, young people and alcohol increased in the first decade of this millennium which may have acted to sustain or accelerate declining drinking trends. However, this dissipated back to baseline levels in the second decade, which may indicate a lag time in recognition of young people's drinking becoming less of a public health 'problem'.

“What constitutes a ‘problem’?” Producing ‘alcohol problems’ through online counselling encounters

Publisher: Elsevier BV

Date: 08-2017

DOI: 10.1016/J.DRUGPO.2017.05.047

Abstract: Typically, health policy, practice and research views alcohol and other drug (AOD) 'problems' as objective things waiting to be detected, diagnosed and treated. However, this approach to policy development and treatment downplays the role of clinical practices, tools, discourses, and systems in shaping how AOD use is constituted as a 'problem'. For instance, people might present to AOD treatment with multiple psycho-social concerns, but usually only a singular AOD-associated 'problem' is considered serviceable. As the assumed nature of 'the serviceable problem' influences what treatment responses people receive, and how they may come to be enacted as 'addicted' or 'normal' subjects, it is important to subject clinical practices of problem formulation to critical analysis. Given that the reach of AOD treatment has expanded via the online medium, in this article we examine how 'problems' are produced in online alcohol counselling encounters involving people aged 55 and over. Drawing on poststructural approaches to problematisation, we not only trace how and what 'problems' are produced, but also what effects these give rise to. We discuss three approaches to problem formulation: (1) Addiction discourses at work (2) Moving between concerns and alcohol 'problems' (3) Making 'problems' complex and multiple. On the basis of this analysis, we argue that online AOD counselling does not just respond to pre-existing 'AOD problems'. Rather, through the social and clinical practices of formulation at work in clinical encounters, online counselling also produces them. Thus, given a different set of circumstances, practices and relations, 'problems' might be defined or emerge differently-perhaps not as 'problems' at all or perhaps as different kinds of concerns. We conclude by highlighting the need for a critical reflexivity in AOD treatment and policy in order to open up possibilities for different ways of engaging with, and responding to, people's needs in their complexity.

Coping strategies in carers of young people with a first episode of psychosis

Publisher: Elsevier BV

Date: 05-2013

DOI: 10.1016/J.SCHRES.2013.02.008

Abstract: Carers of young people with first episode psychosis (FEP) often face burden. Understanding ways in which carers cope is not only important for providing support to them but might maximise patient outcomes. The aim of this study was to examine strategies carers use to cope with the burden of caring for a young person with FEP. The study was part of a randomized controlled trial focusing on the effectiveness of a problem-solving bibliotherapy intervention for carers of FEP patients, in terms of promoting coping and reducing psychological distress. Baseline data on the Ways of Coping (WOC) scale was available for 124 carers aged between 18 and 66 years. Principal component analysis with PROMAX rotation was used to determine the number of factors that could be used to characterise coping behaviour. Regression analyses were used to determine how the factors were related to carers' demographics, burden, psychological well-being and expressed emotion. Approximately half of the carers reported that they frequently use positive coping techniques such as self-talk, active problem solving, and positive reframing. The factor analysis yielded five factors: (i) cognitive-escape coping (ii) optimistic coping (iii) seeking connections (iv) tension reduction and (v) distancing. The relationships between these factors and demographic characteristics, carers' perception of burden, expressed emotion, and psychological distress are reported. Avoidance coping strategies are related to psychological distress, emotional over-involvement, and increased carer burden. Interventions facilitating the use of adaptive problem solving and positive re-appraisal will promote carer coping and reduce psychological distress.

Key differences in treatment-seeking stimulant users attending a specialised treatment service

Publisher: SAGE Publications

Date: 10-01-2017

DOI: 10.1177/1039856216684737

Abstract: Few people who use stimulants seek clinical treatment. This study sought to describe a cohort of stimulant users who attended a stimulant-specific treatment service, Access Point, in Melbourne, Australia between 2008 and 2014. A retrospective audit of the records of adults ( n = 175) who sought treatment for stimulant use at a stimulant-specific outpatient treatment service was conducted. Service users had a median age of 32 (range = 19–54). Most stimulant users were in part- or full-time employment (53.6%) and had stable accommodation (85%). There was a high rate of mental health comorbidity, with over half (52%) reporting a previous history of mental health problems, while one-third (33%) reported previous suicide attempts. There was a high rate (48%) of previous meth hetamine-associated psychosis, which was significantly correlated with frequency of use ( x 2 = 13.698, p = 0.008). This study supports the potential of a targeted and specialised treatment service as a means of early intervention for stimulant users. The high prevalence of meth hetamine-associated psychosis history in this group suggests that frequent use of stimulants increases the risk of psychosis, even among high-functioning in iduals.

Protocol for the methamphetamine approach-avoidance training (MAAT) trial, a randomised controlled trial of personalised approach bias modification for methamphetamine use disorder

Publisher: Springer Science and Business Media LLC

Date: 06-01-2021

DOI: 10.1186/S13063-020-04927-6

Abstract: Globally, meth hetamine use has increased in prevalence in recent years. In Australia, there has been a dramatic increase in numbers of people seeking treatment, including residential rehabilitation, for meth hetamine use disorder (MUD). While residential rehabilitation is more effective for MUD than withdrawal treatment (i.e. “detoxification”) alone, relapse rates remain high, with approximately half of rehabilitation clients using meth hetamine within 3 months of rehabilitation. “Approach bias modification” (ABM) is a computerised cognitive training approach that aims to d en automatically triggered impulses to approach drugs and drug-related stimuli. ABM has been demonstrated to reduce alcohol relapse rates, but no randomised controlled trials of ABM for MUD have yet been conducted. We aim to test whether a novel “personalised” form of ABM, delivered during rehabilitation, reduces post-treatment meth hetamine use, relative to a sham-training control condition. Secondary outcomes will include dependence symptoms, cravings, and approach bias. We aim to recruit 100 participants attending residential rehabilitation for MUD at 3 sites in the Melbourne metropolitan area. Participants will complete baseline measures of meth hetamine use, craving, dependence severity, and approach bias before being randomised to receiving 6 sessions of ABM or “sham” training. In the active condition, ABM will be personalised for each participant, using those meth hetamine images that they rate as most relevant to their recent methods of meth hetamine use as “avoidance” images and using positive images representing their goals or healthy sources of pleasure as “approach” images. Approach bias and craving will be re-assessed following completion of training, and meth hetamine use, dependence, and craving will be assessed 4 weeks and 3 months following discharge from residential treatment. This study is the first randomised controlled trial of ABM for MUD and also the first ABM study to test using a personalised set of both approach and avoid images for ABM training. If effective, the low cost and easy implementation of ABM means it could be widely implemented as a standard part of MUD treatment. Australian New Zealand Clinical Trials Registry ACTRN12620000072910. Registered on 30 January 2020 (prospectively registered): www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378804& isReview=true

Addiction neuroscience and its relevance to clinical practice

Publisher: Wiley

Date: 2007

DOI: 10.1080/09595230601036929

Pituitary volume prospectively predicts internalizing symptoms in adolescence

Publisher: Wiley

Date: 12-11-2011

DOI: 10.1111/J.1469-7610.2010.02337.X

Abstract: Early adolescence is a critical time for the development of both internalizing and externalizing disorders. We aimed to investigate whether pituitary volume, an index of hypothalamic-pituitary-adrenal (HPA) axis function, represents a vulnerability factor for the emergence of internalizing and externalizing symptoms during adolescence using a prospective, longitudinal design. One hundred and fifty-five adolescents completed 3T structural magnetic resonance imaging (MRI), symptom rating scales and a diagnostic interview during early adolescence (M age 12.6 years, SD .5 years) symptom rating scales were re-administered approximately three years later (M age 15.2 years). The volume of the pituitary gland was estimated by manually delineating its structure on MR images. The degree to which pituitary volumes prospectively predicted change in internalizing and externalizing symptoms across the two time-points was assessed using hierarchal linear regression, after controlling for the influence of gender, age, pubertal stage and intracranial volume. Larger pituitary volumes prospectively predicted an increase in internalizing, but not externalizing, symptoms from early adolescence to mid-adolescence. This study provides the first evidence that increased pituitary volume might represent a specific vulnerability marker for the development of internalizing symptoms during early to mid-adolescence.

Web-Based Parenting Program to Prevent Adolescent Alcohol Misuse: Rationale and Development

Publisher: SAGE Publications

Date: 08-2011

DOI: 10.3109/10398562.2011.603334

Abstract: Objectives: Despite substantial evidence demonstrating the important influence that parents have on adolescent drinking, evidence-based preventative interventions that help parents to reduce the risk that their child will develop later alcohol use problems are lacking. Although some face-to-face family-based interventions for adolescent alcohol misuse have been found to be effective, their public health impact is limited by their labour-intensiveness, poor uptake and low adherence. A web-based intervention has the potential to overcome many of these challenges, and was recently recommended by prevention experts as one key way to increase participation rates in preventative interventions. This paper describes the development of www.parentingstrategies.net , a website providing parenting guidelines and a tailored web-based intervention endorsed by longitudinal research evidence and expert consensus. Conclusions: This website provides the first web-based preventative intervention for parents, and has great potential as a family friendly component in the spectrum of interventions that are critically needed to tackle the issue of adolescent alcohol misuse across the community.

Outcomes of an integrated cognitive behaviour therapy (CBT) treatment program for co-occurring depression and substance misuse in young people

Publisher: Elsevier BV

Date: 02-2010

DOI: 10.1016/J.JAD.2009.06.002

Abstract: There are high rates of co-occurring depression among young people with substance use disorders. While there is preliminary evidence for the effectiveness of integrated cognitive behaviour therapy (CBT) in combination with antidepressants among alcohol and substance dependent adolescents and adults with co-existing depression, no studies have examined the effectiveness of integrated CBT interventions in the absence of pharmacotherapy. The aim of the current study was to determine the outcomes of an integrated CBT intervention for co-occurring depression and substance misuse in young people presenting to a mental health setting. Sixty young people (aged 15 to 25), with a DSM-IV diagnosis of Major Depressive Disorder and concurrent substance misuse (at least weekly use in the past month) or disorder were recruited from a public youth mental health service in Melbourne, Australia. Participants received 10 sessions of in idual integrated CBT treatment delivered with case management over a 20-week period. The intervention was associated with significant improvements in depression, anxiety, substance use, coping skills, depressive and substance use cognitions and functioning at mid- (10 weeks) and post- (20 weeks) treatment. These changes were maintained at 6 months follow-up (44 weeks). These results provide preliminary evidence for the effectiveness of the integrated CBT intervention in young people with co-occurring depression and substance misuse. Further studies using randomised controlled designs are required to determine its efficacy.

Affected family members' experience of, and coping with, aggression and violence within the context of problematic substance use: A qualitative study

Publisher: Springer Science and Business Media LLC

Date: 02-06-2017

DOI: 10.1186/S12888-017-1374-3

Alcohol, drug and related health and wellbeing issues among young people completing an online screen

Publisher: SAGE Publications

Date: 30-09-2016

DOI: 10.1177/1039856216671657

Abstract: Despite high levels of alcohol use, drug use and risky behaviors, rates of help-seeking amongst young people are typically low. This study explored the profile of young people (under the age of 25 years) completing an online screen, assessing substance use problem severity and wellbeing in comparison with adults completing the same screen, so as to inform development of better targeted approaches for this in-need population. Between 2012 and 2014, an online alcohol and drug screen was promoted across Australia on a national online counseling service. The screen assessed severity of substance use, mental health and wellbeing. A total of 2939 screens were completed between December 2012 and May 2014, with 18% completed by young people. Young people reported a high severity of substance use problems (44% reported likely drug dependence) and reported significantly poorer mental health and wellbeing than adults completing the screen. This suggests that there is a population of young people in need of support who could be initially engaged through online screening. Online screening should be a key component of engagement strategies for adolescent and early adult help-seeking.

Substance use and the adolescent brain: A toxic combination?

Publisher: SAGE Publications

Date: 11-2007

DOI: 10.1177/0269881107078309

Abstract: Early onset substance use has consistently been associated with increased risk for a range of adverse outcomes in late adolescence and early adulthood. However, the mechanisms that underlie this relationship are not fully understood. Recent advances in developmental neuro-science, together with emerging literature on early onset substance use, suggest that the adolescent brain may be more vulnerable to the effects of addictive substances because of the extensive neuromaturational processes that are occurring during this period. Such findings are suggestive of disrupted developmental trajectories in early onset users, although there is growing evidence that high-risk youths have premorbid neurobiological vulnerabilities. Prospective studies investigating neurobiological correlates and sequelae of early adolescent drug use are urgently required to inform appropriate public health responses.

Young people with depression and their satisfaction with the quality of care they receive from a primary care youth mental health service: A qualitative study

Publisher: Wiley

Date: 30-05-2012

DOI: 10.1111/J.1365-2702.2012.04086.X

Abstract: Aim. To examine how satisfied young people with depression are with the quality of care they receive from clinicians of a primary care service for young people with mental health problems. Background. There is a high prevalence of youth depression, but few studies have been undertaken to examine whether young people are satisfied with the care they receive in primary care youth mental health services. Design. Qualitative interpretative phenomenological analysis. Method. In idual, semi‐structured, in‐depth, audio‐recorded interviews were carried out between March and September 2009. A purposive s le of 26 young people with depression, average age 18 years, were recruited through clinicians of a primary care service for young people with mental health problems, in Melbourne. Results. Three overlapping themes highlight youth participants’ satisfaction with care: First, clinicians being youth‐friendly, highlights how, overall, clinicians are perceived as approachable and supportive, understanding and non‐judgemental. Second, clinicians adopting a broad‐based style of care illustrates that their use primarily of psychosocial therapies, and the judicious use of antidepressant medication, is received favourably by youth. Third, care facilitating recovery highlights that clinicians’ youth‐friendly and broad‐based approach enables a therapeutic dialogue to be established with the young people, contributing to recovery from depression recovery, in turn, enhances satisfaction with clinicians. Conclusion. Youth‐friendliness is an important expectation of mental health nurses and other clinicians within the youth service. This engagement style provides a useful framework for clinicians to adopt a broad‐based approach to care. Ultimately, care should facilitate recovery from depression, and this strengthens satisfaction with mental health nurses and other clinicians. Relevance to clinical practice. The findings make an important contribution to knowledge and research in mental health nursing. In particular, youth‐friendliness is an important prerequisite for continuing engagement with services, and a broad‐based approach to care should be adopted.

Hippocampal harms, protection and recovery following regular cannabis use

Publisher: Springer Science and Business Media LLC

Date: 12-01-2016

DOI: 10.1038/TP.2015.201

Abstract: Shifting policies towards legalisation of cannabis for therapeutic and recreational use raise significant ethical issues for health-care providers seeking evidence-based recommendations. We investigated whether heavy cannabis use is associated with persistent harms to the hippoc us, if exposure to cannabidiol offers protection, and whether recovery occurs with abstinence. To do this, we assessed 111 participants: 74 long-term regular cannabis users (with an average of 15.4 years of use) and 37 non-user healthy controls. Cannabis users included subgroups of participants who were either exposed to Δ9-tetrahydrocannabinol (THC) but not to cannabidiol (CBD) or exposed to both, and former users with sustained abstinence. Participants underwent magnetic resonance imaging from which three measures of hippoc al integrity were assessed: (i) volume (ii) fractional anisotropy and (iii) N -acetylaspartate (NAA). Three curve-fitting models across the entire s le were tested for each measure to examine whether cannabis-related hippoc al harms are persistent, can be minimised (protected) by exposure to CBD or recovered through long-term abstinence. These analyses supported a protection and recovery model for hippoc al volume ( P =0.003) and NAA ( P =0.001). Further pairwise analyses showed that cannabis users had smaller hippoc al volumes relative to controls. Users not exposed to CBD had 11% reduced volumes and 15% lower NAA concentrations. Users exposed to CBD and former users did not differ from controls on any measure. Ongoing cannabis use is associated with harms to brain health, underpinned by chronic exposure to THC. However, such harms are minimised by CBD, and can be recovered with extended periods of abstinence.

Brief intervention in an emergency department reduces violence in the short term but not alcohol misuse in at-risk adolescents

Publisher: BMJ

Date: 18-12-2010

DOI: 10.1136/EBMH1133

Inhalant abuse among adolescents: Neurobiological considerations

Publisher: Wiley

Date: 05-2008

DOI: 10.1038/BJP.2008.76

Stigma experience of families supporting an adult member with substance misuse

Publisher: Wiley

Date: 08-06-2018

DOI: 10.1111/INM.12355

Abstract: Stigmatization of families supporting an adult member with substance misuse is common and undermines their capacity to support the person and maintain their own well-being. The aims of the present study were to understand affected family members (AFMs)' experience of stigma within the context of substance misuse, and to explicate what steps, if any, they took to try to counteract stigma and social isolation. Semistructured, audio-recorded qualitative interviews were conducted with 31 AFMs from Victoria in Australia. Interpretative phenomenological analysis was used to guide data collection and analysis. Two main themes and related subthemes abstracted from the data illustrated how participants perceived and responded to stigma associated with a family member's substance misuse: 'engaging in secrecy, and minimizing contact with others' and 'lack of knowledge and empathy, and judgmental attitudes reinforcing isolation'. A third theme, 'adopting measures to moderate the effect of stigma', highlights how some attempted to respond to stigma by challenging informal supports' misconceptions about substance misuse, and being open selectively with others about their situation. Stigma against AFMs should be identified and challenged. Mental health nurses and other clinicians in the alcohol and other drugs field are in a strong position to support AFMs, with a particular focus on reducing courtesy stigma, challenging some clinicians' judgmental attitudes, and improving ways of communicating with families.

Early adolescent drinking and cannabis use predicts later sleep-quality problems

Publisher: American Psychological Association (APA)

Date: 05-2019

DOI: 10.1037/ADB0000453

Abstract: A range of biopsychosocial changes occur during adolescence that contribute to changes in the sleep-wake system. Use of alcohol and cannabis also increases during early adolescence however, limited studies have examined the associations between changes in the use of alcohol and cannabis and later sleep problems. Participants (

Change Strategies and Associated Implementation Challenges: An Analysis of Online Counselling Sessions

Publisher: Springer Science and Business Media LLC

Date: 17-12-2017

DOI: 10.1007/S10899-016-9661-3

Abstract: Self-change is the most frequent way people limit or reduce gambling involvement and often the first choice of people experiencing gambling-related problems. Less well known is the range of change strategies gamblers use and how these are selected, initiated or maintained. This study examined change strategies discussed in counselling transcripts from 149 clients who accessed a national online gambling help service in Australia. Using thematic analysis, we identified the presence of six change strategies cash control and financial management, social support, avoiding or limiting gambling, alternative activities, changing thoughts and beliefs, and self-assessment and monitoring. Four implementation issues were also identified a mismatch between need and strategy selection or maintenance importance and readiness versus the cost of implementation poor or unplanned transitions between strategies and failure to review the helpfulness of strategies resulting in premature abandonment or unhelpful prolonged application. This study is the first to identify change strategies discussed in online counselling sessions. This study suggests change strategies are frequently discussed in online counselling sessions and we identified multiple new actions associated with change strategies that had not previously been identified. However, multiple implementation issues were identified and further work is required to determine the helpfulness of change strategies in terms of their selection, initiation and maintenance.

Improved Quality of Life Following Addiction Treatment Is Associated with Reductions in Substance Use

Publisher: MDPI AG

Date: 06-09-2019

DOI: 10.3390/JCM8091407

Abstract: People seeking treatment for substance use disorders (SUD) ultimately aspire to improve their quality of life (QOL) through reducing or ceasing their substance use, however the association between these treatment outcomes has received scant research attention. In a prospective, multi-site treatment outcome study (‘Patient Pathways’), we recruited 796 clients within one month of intake from 21 publicly funded addiction treatment services in two Australian states, 555 (70%) of whom were followed-up 12 months later. We measured QOL at baseline and follow-up using the WHOQOL-BREF (physical, psychological, social and environmental domains) and determined rates of “SUD treatment success” (past-month abstinence or a statistically reliable reduction in substance use) at follow-up. Mixed effects linear regression analyses indicated that people who achieved SUD treatment success also achieved significantly greater improvements in QOL, relative to treatment non-responders (all four domains p 0.001). Paired t-tests indicated that non-responders significantly improved their social (p = 0.007) and environmental (p = 0.033) QOL however, their psychological (p = 0.088) and physical (p = 0.841) QOL did not significantly improve. The findings indicate that following treatment, QOL improved in at least some domains, but that reduced substance use was associated with both stronger and broader improvements in QOL. Addressing physical and psychological co-morbidities during treatment may facilitate reductions in substance use.

Moyamoya disease in a patient with schizophrenia

Publisher: Cambridge University Press (CUP)

Date: 07-2003

DOI: 10.1017/S1355617703950132

Abstract: We present the case of a 23-year-old Vietnamese male with a 2-year history of a psychotic illness marked by prominent negative symptoms, fatuousness and disturbed behavior. Neuroimaging revealed a prominent vascular flow void affecting the middle and anterior cerebral arteries, with associated increased collateral supply to the frontal cortex, consistent with Moyamoya disease. Neurological examination was unremarkable however, neuropsychological assessment revealed significant executive dysfunction, including stimulus-driven behavior. Whilst the diagnosis of schizophrenia and Moyamoya disease may be coincidental, an interaction between the 2 diseases may have led to some of the atypical features of this case, including prominent executive dysfunction and marked sensitivity to psychotropic medication. We discuss the nature of possible interactions between the 2 conditions. This case also highlights the importance of re-evaluating patients with atypical or treatment-resistant psychoses for cerebral pathology. ( JINS , 2003, 9 , 806–810.)

Anhedonia in substance use disorders: A systematic review of its nature, course and clinical correlates

Publisher: SAGE Publications

Date: 22-11-2014

DOI: 10.1177/0004867413508455

Abstract: There is growing evidence that anhedonia is a commonly experienced symptom among substance-using populations. This systematic review synthesises findings across a range of substances to address questions regarding the time course of anhedonia, how anhedonia relates to other symptoms of substance dependence and whether it is similarly prevalent across all addictive drugs. A literature search was conducted on PubMed, PsycINFO and MEDLINE, yielding 32 studies that used self-report measures of anhedonia among participants with a history of a substance abuse, dependence or long-term daily use of addictive substances. Findings from these studies indicate that anhedonia (1) is elevated in s les dependent on a range of substances (2) typically appears as a consequence of substance abuse or dependence, and diminishes with abstinence and (3) predicts increased drug cravings and the likelihood of relapse in those attempting abstinence. The common experience of anhedonia in substance-dependent populations, and its relationship to relapse, emphasises the importance of developing therapeutic interventions that specifically target anhedonia in the treatment of all substance use disorders.

Patterns of family conflict and their impact on substance use and psychosocial outcomes in a sample of young people in treatment

Publisher: Informa UK Limited

Date: 18-11-2013

DOI: 10.1080/17450128.2013.855858

Psychoactive drug and medication use among patients referred to a tertiary sleep laboratory population

Publisher: Elsevier BV

Date: 12-2020

DOI: 10.1016/J.PSYCHRES.2020.113545

Risky alcohol consumption among women in Australia attending breast screening services: an exploratory cross‐sectional study

Publisher: Wiley

Date: 14-04-2023

DOI: 10.1111/ADD.16191

Abstract: Alcohol is a major modifiable risk factor for female breast cancer, with breast cancer risk now associated with substantially lower consumption levels than those previously deemed safe. This study sought to measure risky drinking among women attending breast screening services in Australia according to new national alcohol guidelines and to compare daily, weekly and recent (past 12 months) consumption to Australian gender and age population norms. This study was a retrospective analysis of cross‐sectional data from the Lifepool Project (collected October 2011–January 2016) in Victoria, Australia, comprising a convenience s le of women attending breast screening services aged 40+ years. Typical and heavy alcohol consumption patterns over the previous 12 months (frequency, quantity), socio‐demographic (e.g. age, education) and health‐related (e.g. menopause status, breast cancer history) characteristics. Primary outcomes were the proportion of women drinking at a level exceeding new guidelines for weekly and daily alcohol consumption. Of 49 240 women, mean age was 59.94 years (standard deviation = 7.14, range = 40–94 years). Most women had consumed alcohol during the past 12 months [41 628, 85.48%, 95% confidence interval (CI) = 85.16, 85.79]. One in five women (8464, 18.34%, 95% CI = 17.99, 18.69) were drinking at a level exceeding new national guidelines for weekly consumption (i.e. greater than 10 standard drinks per week), and one in six (7446, 15.60%, 95% CI = 15.28, 15.93) were exceeding new guidelines for consumption on a single day (i.e. greater than four standard drinks on any 1 day, more than once per month). The proportion of women in this s le drinking daily (4.21–11.19%), weekly (34.73–50.71%) and in the past 12 months (74.96–90.81%) was significantly greater among nearly all age groups (by decade), compared with Australian gender and age norms [drinking daily (3.4–9.1%), weekly (27.1–37.6%) and in the past 12 months (64.4–81.9%)]. There appears to be a high prevalence of risky alcohol consumption among a large convenience s le of breast screening service clients in Australia using new national alcohol guidelines introduced in December 2020.

Typology of alcohol consumers in five Australian nighttime entertainment districts

Publisher: Wiley

Date: 14-12-2016

DOI: 10.1111/DAR.12370

Abstract: Understanding how types of alcohol consumers differ is important for public policy targeted at reducing adverse events. The aims of the present study were to identify typologies of alcohol consumers in Australian nighttime entertainment districts based on risk factors for harm and to examine variation between the identified groups in drinking setting and harms. Street-intercept surveys were conducted with 5556 alcohol consumers in and around licensed venues in five Australian cities between November 2011 and June 2012. Latent class analysis identified groups based on age and sex, and blood alcohol concentration, pre-drinking, energy drink use and illicit drug use during that night. Four classes were identified: general patron group (33%), young pre-drinker group (27%), intoxicated male pre-drinker group (31%) and intoxicated illicit drug male group (9%). The proportion of the general patron group interviewed decreased over the night, while the other groups increased (particularly in regional cities). As compared with the general patron group, the remaining three groups reported increased odds of being involved in aggression and any alcohol-related injuries in the past 3 months, with highest rates of harm amongst the intoxicated illicit drug male group. Alcohol consumers in nighttime entertainment districts are not a homogeneous group. One-third have a low likelihood of risky consumption practices however, representation of this consumer class diminishes throughout the night. Elevated harms amongst groups characterised by certain risk factors (e.g. pre-drinking and illicit drug use) emphasise the importance of addressing these behaviours in public policy. [Peacock A, Norman T, Bruno B, Pennay, Droste N, Jenkinson R, Quinn B, Lubman DI, Miller P. Typology of alcohol consumers in five Australian nighttime entertainment districts. Drug Alcohol Rev 2016 :539-548].

Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders

Publisher: Elsevier BV

Date: 05-2017

DOI: 10.1016/J.PSYCHRES.2017.02.028

Abstract: We examined the lifetime experience of hallucinations and delusions associated with transient meth hetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent meth hetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110) (b) psychotic symptoms only when using meth hetamine (transient MAP, n=85) (c) psychotic symptoms both when using meth hetamine and when abstaining from meth hetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use meth hetamine.

‘Only take the money you want to lose’ strategies for sticking to limits in electronic gaming machine venues

Publisher: Informa UK Limited

Date: 22-05-2019

DOI: 10.1080/14459795.2019.1617330

Psychometric properties, validity, and reliability of the Temporal Experience of Pleasure Scale state version in an opioid-dependent sample

Publisher: Elsevier BV

Date: 04-2016

DOI: 10.1016/J.DRUGALCDEP.2016.02.011

Abstract: In iduals with substance dependence commonly experience anhedonia. Theories of anhedonia distinguish between anticipatory and consummatory reward deficits, with the Temporal Experience of Pleasure Scale (TEPS) the first self-report scale to separately measure these two constructs. Several psychometric studies have analysed the trait version of the TEPS, but the state version of the TEPS has not been previously validated. We examined the psychometric properties of the state version of the TEPS in 121 in iduals with opiate dependence (81% Australian-born), to confirm its 2-factor structure and examine the internal consistency, convergent and ergent validity, test-retest reliability, and performance as a state measure. Confirmation of the 2-factor solution required removal of two items and allowing correlation between residuals of three pairs of highly-similar items. The resulting consummatory and anticipatory scales correlated strongly with each other (r=.76), suggesting poor ergent validity between them. Nevertheless, the scale showed good internal consistency (Chronbach's α: anticipatory=.90 consummatory=.84 total=.92), convergent (TEPS total and Snaith-Hamilton Pleasure Scale r=-.76) and ergent validity (-.38<r<-.10 for measures of negative affect, anxiety, and alexithymia) with other psychological measures, and test-retest reliability. Changes in TEPS scores between baseline and 1-month follow-up correlated well with changes in scores on other state anhedonia and positive affect measures, suggesting that the TEPS state version functions well as a state measure. In opioid-dependent participants, the TEPS state version appeared to have good validity as a measure of state anhedonia. However, evidence for its ability to distinguish between consummatory and anticipatory anhedonia was weak.

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

Publisher: Wiley

Date: 04-04-2019

DOI: 10.1111/HEX.12886

Alcohol and cardiovascular risk

Publisher: Springer Singapore

Date: 2016

DOI: 10.1007/978-981-287-206-7_8

Problem gambling and substance use in patients attending community mental health services

Publisher: Akademiai Kiado Zrt.

Date: 12-2017

DOI: 10.1556/2006.6.2017.077

Going up in smoke: Tobacco smoking is associated with worse treatment outcomes in mania

Publisher: Elsevier BV

Date: 09-2008

DOI: 10.1016/J.JAD.2008.01.018

Abstract: This study aimed to compare the treatment responses between smokers and non-smokers in bipolar mania clinical trials. Post-hoc analysis was conducted on data collected from three double-blind, randomised controlled trials in bipolar mania that had similar inclusion criteria. Patients were randomised to olanzapine (N=70) or placebo (N=69) for 3 weeks in Trial 1, olanzapine (N=234) or haloperidol (N=216) for 12 weeks in Trial 2, and olanzapine (N=125) or alproex (N=126) for 47 weeks in Trial 3. This study analysed the Young Mania Rating Scale (YMRS) total scores and Clinical Global Impressions scale for bipolar disorder (CGI-BP) mania severity scores between smokers and non-smokers for each trial and for the pooled data from all three trials, using a mixed-effects model repeated measures approach. For the pooled data, non-smokers showed superior treatment outcomes on both the YMRS (P=0.002) and CGI-BP (P<0.001), as well as longer time to discontinuation for any cause utilising Kaplan-Meier survival curves. For the in idual trials, non-smokers showed greater improvement than smokers on both CGI-BP and YMRS in both treatment arms of Trial 2 (CGI-BP: haloperidol P=0.011, olanzapine P=0.042 YMRS: haloperidol P=0.010, olanzapine P=0.019), and in the olanzapine arm of Trial 3 (CGI-BP: P=0.002 YMRS: P=0.006). No significant difference in outcomes was found between smokers and non-smokers in Trial 1. Post-hoc design, categorical definition of smoking status, unavailable antipsychotic drug levels, confounding effects of trial medications and substance abuse. Smoking appears to be associated with worse treatment outcomes in mania.

Invited comment

Publisher: Wiley

Date: 29-03-2005

DOI: 10.1111/J.1600-0447.2004.00481.X

Re-thinking pre-drinking: Implications from a sample of teenagers who drink in private settings

Publisher: Elsevier BV

Date: 02-2018

DOI: 10.1016/J.DRUGPO.2017.11.024

The emergence of a recovery movement for alcohol and drug dependence

Publisher: SAGE Publications

Date: 19-03-2012

DOI: 10.1177/0004867412443137

An accelerated hepatitis B vaccination schedule for young drug users

Publisher: Elsevier BV

Date: 08-2005

DOI: 10.1111/J.1467-842X.2005.TB00197.X

Abstract: To determine completion rates for an accelerated hepatitis B vaccine (HBV) program among a population of young drug users. Between January 2001 and May 2002, a three-dose course of HBV vaccine (0, 7 and 21 days) was offered free to all drug users (aged 22 years or younger) accessing two outreach sites of a youth-focused support and drug treatment service in metropolitan Melbourne, Australia. Clients were offered vaccination in any safe environment of their choice. An audit was conducted on the health records of participating clients. Number of completed vaccinations settings in which vaccinations were completed. Ninety young people accepted vaccination, with 71% completing the full course. The majority preferred to receive vaccination at drug treatment outreach sites (53%). An accelerated vaccination schedule appears acceptable to young drug users, suggesting that vaccination programs can be successful when barriers to immunisation are appropriately identified and addressed.

Australian adolescents’ beliefs and help-seeking intentions towards peers experiencing symptoms of depression and alcohol misuse

Publisher: Springer Science and Business Media LLC

Date: 16-08-2017

DOI: 10.1186/S12889-017-4655-3

Challenges in delivering telemedicine to vulnerable populations: experiences of an addiction medical service during COVID‐19

Publisher: AMPCo

Date: 07-08-2021

DOI: 10.5694/MJA2.51213

Poppy seed tea dependence requiring depot buprenorphine treatment

Publisher: Wiley

Date: 08-11-2021

DOI: 10.5694/MJA2.51334

Revision of the Australian guidelines to reduce health risks from drinking alcohol

Publisher: Wiley

Date: 28-11-2021

DOI: 10.5694/MJA2.51336

Development of Brain Network Connectivity in Risky Drinkers During Adolescence

Publisher: Cold Spring Harbor Laboratory

Date: 27-10-2020

DOI: 10.1101/2020.10.22.20217992

Abstract: Alcohol consumption is common in adolescence, a time when the human brain undergoes substantial development, raising concerns about the neurodevelopmental impact of drinking alcohol, especially at high levels. Risky drinking may adversely affect the developing white matter, comprised of axonal fibre pathways that integrate anatomically distributed, and functionally specialised, neural systems. We used diffusion-weighted magnetic resonance imaging (MRI) to perform the first prospective, comprehensive and regionally unbiased connectome-wide analysis of longitudinal changes in inter-regional structural connectivity between 16.5 and 18.8 years of age, comparing adolescents who reported frequent risky drinking ( n = 20) with those who reported limited risky drinking ( n = 19) across this developmental period. We found no difference in the development of structural connectivity between these groups, regardless of whether inter-regional connections were quantified using streamline count, fractional anisotropy, mean diffusivity, axial diffusivity, or radial diffusivity. These findings suggest that risky drinking may have limited adverse effects on the development of inter-regional structural connectivity during mid to late adolescence.

Disclosures of harming others during their most recent drinking session: Findings from a large national study of heavy-drinking adolescents

Publisher: Wiley

Date: 28-06-2022

DOI: 10.1111/DAR.13336

Abstract: The extant Alcohol's Harms to Others (AHTO) literature is largely comprised of reports from victims. We investigated AHTO from perpetrators' perspectives, including how harms were associated with in idual characteristics, and alcohol quantities consumed during the perpetration incident. Participants ( N = 2932) were 14–19 years old, recruited primarily through social media and screened as risky drinkers. They completed face‐to‐face ( n = 594) or self‐administered ( n = 2338) surveys. They self‐reported whether during their last risky drinking session (LRDS) they had perpetrated any verbal abuse, physical abuse or property damage. A multinomial logistic regression examined whether nine factors were associated with perpetrating zero, one or 2+ categories of AHTO. Eleven percent ( n = 323) reported perpetrating at least one form of AHTO (7.5% verbal, 1.9% physical and 4.6% property). Perpetration of AHTO at LRDS was uniquely associated with: younger age, male gender, experiences of childhood physical punishment, greater perpetration incident‐specific drinking, concurrent illicit drug use, and less frequent use of safety strategies while drinking in the past 12 months. Controlling for the other variables, an increase of six Australian standard drinks (60 g of alcohol) increased the odds of perpetration by 15% [95% confidence interval (CI) adjusted odds ratio (AOR) 1.08, 1.23], and an increase of 15 Australian standard drinks increased the odds by 42% (95% CI AOR 1.20, 1.69). In idual characteristics, larger quantities of alcohol consumed, and a disinclination to practice harm reduction lified risk of AHTO perpetration. This has implications for health promotion and risk prevention/reduction strategies.

Web-Based Counseling for Problem Gambling: Exploring Motivations and Recommendations

Publisher: JMIR Publications Inc.

Date: 24-05-2013

DOI: 10.2196/JMIR.2474

Description of Trends over the Week in Alcohol-Related Ambulance Attendance Data

Publisher: MDPI AG

Date: 19-04-2023

DOI: 10.3390/IJERPH20085583

Abstract: Alcohol harms are often determined using a proxy measure based on temporal patterns during the week when harms are most likely to occur. This study utilised coded Australian ambulance data from the Victorian arm of the National Ambulance Surveillance System (NASS) to investigate temporal patterns across the week for alcohol-related ambulance attendances in 2019. These patterns were examined by season, regionality, gender, and age group. We found clear temporal peaks: from Friday 6:00 p.m. to Saturday 3:59 a.m. for both alcohol-involved and alcohol-intoxication-related attendance, from Saturday 6:00 p.m. to Sunday 4:59 a.m. for alcohol-involved attendances, and from Saturday 5:00 p.m. to Sunday 4:49 a.m. for alcohol-intoxication-related attendances. However, these temporal trends varied across age groups. Additionally, hours during Thursday and Sunday evenings also demonstrated peaks in attendances. There were no substantive differences between genders. Younger age groups (18–24 and 25–29 years) had a peak of alcohol-related attendances from 7:00 p.m. to 7:59 a.m. on Friday and Saturday nights, whereas the peak in attendances for 50–59 and 60+ years was from 5:00 p.m. to 2:59 a.m. on Friday and Saturday nights. These findings further the understanding of the impacts of alcohol during different times throughout the week, which can guide targeted policy responses regarding alcohol use and health service capacity planning.

Neuroscience in gambling policy and treatment: an interdisciplinary perspective

Publisher: Elsevier BV

Date: 06-2017

DOI: 10.1016/S2215-0366(16)30369-8

Energy drinks: Health risks and toxicity

Publisher: AMPCo

Date: 04-2012

DOI: 10.5694/MJA12.10211

The incidence and temporal patterns of use of amphetamine-type stimulant use in traffic-related ambulance attendances from 2015 to 2020 in Victoria, Australia.

Publisher: Alcohol Research Documentation, Inc.

Date: 2022

DOI: 10.15288/JSAD.22-00050

Toluene misuse and long-term harms: a systematic review of the neuropsychological and neuroimaging literature.

Publisher: Elsevier BV

Date: 07-2008

DOI: 10.1016/J.NEUBIOREV.2008.01.006

Abstract: Organic solvent abuse is associated with increased risk for serious medical, neurological, and neuropsychological impairments. While animal research suggests that exposure to organic solvents (especially toluene) may be neurotoxic, much less is known about the consequences of long-term exposure in humans. We reviewed neuroimaging and neuropsychological studies examining chronic toluene misuse in humans. Thirty empirical studies fulfilled the inclusion and exclusion criteria, including case studies (n=9) as well as group studies with (n=11) and without a control group (n=10). Our review indicates that toluene preferentially affects white matter (relative to gray matter) structures and periventricular/subcortical (relative to cortical) regions. The lipid-dependent distribution and pharmacokinetic properties of toluene appears to explain the pattern of MRI abnormalities, as well as the common symptoms and signs of toluene encephalopathy. The commonly observed neuropsychological deficits such as impairments in processing speed, sustained attention, memory retrieval, executive function and language, are also consistent with white matter pathology. We discuss the implications of these findings in the context of a neurodevelopmental framework, as well as the neuropathology and pathophysiology of toluene abuse. We also propose a set of recommendations to guide future research in this area.

Successful inhibitory control over an immediate reward is associated with attentional disengagement in visual processing areas

Publisher: Elsevier BV

Date: 09-2012

DOI: 10.1016/J.NEUROIMAGE.2012.05.040

Abstract: We examined the neural basis of the capacity to resist an immediately rewarding stimulus in order to obtain a larger delayed reward. This was investigated with a Go/No-go task employing No-go targets that provided two types of reward outcomes. These were contingent on inhibitory control performance: failure to inhibit Reward No-go targets provided a small monetary reward with immediate feedback while successful inhibitory control resulted in larger rewards with delayed feedback based on the highest number of consecutive inhibitions. We observed faster Go trial responses with maintained levels of inhibition accuracy during the Reward No-go condition compared to a neutral No-go condition. Comparisons between conditions of BOLD activity showed successful inhibitory control over rewarding No-Go targets was associated with hypoactivity in regions previously associated with regulating emotion and inhibitory control, including insula and right inferior frontal gyrus. In addition, regions previously associated with visual processing centers that are modulated as a function of visual attention, namely the left fusiform and right superior temporal gyri, were hypoactive. These findings suggest a role for attentional disengagement as an aid to withholding response over a rewarding stimulus and are consistent with the notion that gratification can be delayed by directing attention away from immediate rewards.

Treating the Untreatable in Art and Heritage Materials: Ultrafast Laser Cleaning of “Cloth-of-Gold”

Publisher: American Chemical Society (ACS)

Date: 17-01-2015

DOI: 10.1021/LA504400H

Abstract: Laser cleaning provides art and heritage conservators with an alternative means to restore objects when traditional chemical and mechanical methods are not viable. However, long (>nanosecond) laser pulses can cause unwanted damage from photothermal processes and provide limited control over ablation depth. Ultrashort (<picosecond) pulse lasers are emerging as a more appropriate tool for cleaning historic artifacts because of their unique ability to avoid heat- and shock-wave generation, thus minimizing collateral damage of the underlayers, and to remove material with near-nanometer precision. Here we demonstrate the effectiveness of ultrashort pulses by cleaning 19th century military gold braid without any detrimental effects on the gold foil or the underlying silk thread structure. The results are compared with nanosecond-pulse laser treatment that damages the surface structure. By introducing in situ feedback control of the laser ablation via laser-induced breakdown spectroscopy (LIBS) monitoring of the ablated plume, we are able to halt the cleaning process just as the contaminant layer is completely removed. This technique allows ultrafast laser ablation to extend the armory of conservation treatments, enabling restoration of a range of complex and fragile heritage objects previously untreatable by conventional means.

Models of co-occurring substance misuse and psychosis: Are personality traits the missing link?

Publisher: Wiley

Date: 12-2004

DOI: 10.1080/09595230412331324545

Abstract: Traditional models of co-occurring substance misuse in psychosis, including the vulnerability and coping (self-medication) hypotheses, have tended to focus on state-specific factors, such as the severity of substance misuse or psychotic symptoms. In contrast, more recent personality models posit that co-morbidity is related to in idual differences in stable trait-specific personality variables that underlie affective outcomes, coping strategies and subsequent risk for substance use. This paper reviews the current evidence base for these three models, and suggests that future research examine the inter-relationships between trait and state-specific personality, affective and behavioural variables on co-morbidity.

Corpus callosum size and shape alterations in adolescent inhalant users

Publisher: Wiley

Date: 29-09-2013

DOI: 10.1111/J.1369-1600.2011.00364.X

Abstract: Inhalants, frequently abused during adolescence, are neurotoxic to white matter. We investigated the impact of inhalant misuse on the morphology of the corpus callosum (CC), the largest white matter bundle in the brain, in an adolescent s le of inhalant users [n = 14 mean age = 17.3 standard deviation (SD) = 1.7], cannabis users (n = 11 mean age = 19.7 SD = 1.7) and community controls (n = 9 mean age = 19.5 SD = 2.6). We identified significant morphological differences in the CC among inhalant users compared with community controls. There were no morphological differences between inhalant and cannabis users. Our findings may represent the early stages of neurobiological damage associated with chronic inhalant misuse.

Motives for substance use among young people seeking mental health treatment

Publisher: Wiley

Date: 28-07-2008

DOI: 10.1111/J.1751-7893.2008.00076.X

Abstract: To explore substance use motives among young people seeking mental health treatment. Participants consisted of 103 young people seeking mental health treatment, who had used drugs or alcohol in the past year. The young people completed a 42-item substance use motives measure based on the Drinking Motives Measure for their most frequently used substance in the past year. Exploratory factor analysis of the substance use motives scale indicated the young people reported using substances for positive and negative drug effects, to socialize with their peers, and to cope with a negative affect. They did not report using substances for enhancement or conformity motives. Coping motives predicted the presence of a current substance use disorder. The findings support the need for integrated treatment approaches within mental health settings, particularly targeted at young people with co-occurring mental health and substance use problems.

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

Publisher: Informa UK Limited

Date: 2022

DOI: 10.2147/SAR.S304566

Effect of craving induction on inhibitory control in opiate dependence

Publisher: Springer Science and Business Media LLC

Date: 28-09-2012

DOI: 10.1007/S00213-011-2512-0

Abstract: Current neurobiological models of addiction posit that drug seeking is much more likely to occur during emotionally charged states (such as craving), as deficits in inhibitory control become more pronounced during heightened motivational states. The purpose of this study was to examine the effect of cue-induced craving states on attention and inhibitory control within addicted in iduals. We tested the performance of 39 opiate-dependent in iduals on cognitive measures of attention (Digit Span, Digit Symbol, and Telephone Search) and inhibitory control (Counting Stroop and Go-No-Go) both before and after exposure to an autobiographical craving script. A non-drug using healthy control group (n = 19) performed the same tasks before and after listening to a relaxation tape. Following craving induction, opiate-dependent in iduals demonstrated improved performance on tests of processing speed and attentional span (consistent with the practice effect observed in controls) and increased their response errors on the Stroop task (in contrast to controls), while selective attention was unaffected. In idual differences in compulsivity mediated the association between craving and Stroop performance, such that low-compulsive (but not high-compulsive) in iduals committed more response errors after craving induction. These findings challenge the notion of cue-induced craving as a primary trigger of disrupted cognition and drug-seeking behavior in addicted in iduals, and raise the need to explore in idual differences in compulsivity when addressing the links between craving and loss of control within research and clinical settings.

Investigation of the effects of femtosecond laser metal surface texturing on bonding of PA6 to steel

Publisher: Elsevier BV

Date: 2019

DOI: 10.1016/J.PROMFG.2019.02.143

Behaviour change strategies for problem gambling: an analysis of online posts

Publisher: Informa UK Limited

Date: 08-02-2018

DOI: 10.1080/14459795.2018.1432670

Psychological interventions for alcohol misuse among people with co-occurring depression or anxiety disorders: a systematic review.

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.1016/J.JAD.2011.08.004

Abstract: Depression, anxiety and alcohol misuse frequently co-occur. While there is an extensive literature reporting on the efficacy of psychological treatments that target depression, anxiety or alcohol misuse separately, less research has examined treatments that address these disorders when they co-occur. We conducted a systematic review to determine whether psychological interventions that target alcohol misuse among people with co-occurring depressive or anxiety disorders are effective. We systematically searched the PubMed and PsychINFO databases from inception to March 2010. In idual searches in alcohol, depression and anxiety were conducted, and were limited to 'human' published 'randomized controlled trials' or 'sequential allocation' articles written in English. We identified randomized controlled trials that compared manual guided psychological interventions for alcohol misuse among in iduals with depressive or anxiety disorders. Of 1540 articles identified, eight met inclusion criteria for the review. From each study, we recorded alcohol and mental health outcomes, and other relevant clinical factors including age, gender ratio, follow-up length and drop-out rates. Quality of studies was also assessed. Motivational interviewing and cognitive-behavioral interventions were associated with significant reductions in alcohol consumption and depressive and/or anxiety symptoms. Although brief interventions were associated with significant improvements in both mental health and alcohol use variables, longer interventions produced even better outcomes. There is accumulating evidence for the effectiveness of motivational interviewing and cognitive behavior therapy for people with co-occurring alcohol and depressive or anxiety disorders.

A Personalized Approach Bias Modification Smartphone App (“SWiPE”) to Reduce Alcohol Use: Open-Label Feasibility, Acceptability, and Preliminary Effectiveness Study

Publisher: JMIR Publications Inc.

Date: 10-12-2021

DOI: 10.2196/31353

Abstract: Approach bias modification (ApBM), a computerized cognitive intervention that trains people to “avoid” alcohol-related images and “approach” nonalcohol images, reduces the likelihood of relapse when administered during residential alcohol treatment. However, most in iduals experiencing alcohol problems do not require, do not seek, or have difficulty accessing residential treatment. Smartphone-delivered ApBM could offer an easily accessible intervention to reduce alcohol consumption that can be personalized (eg, allowing selection of personally relevant alcohol and positive nonalcohol training images) and gamified to optimize engagement. We examined the feasibility, acceptability, and preliminary effectiveness of “SWiPE,” a gamified, personalized alcohol ApBM smartphone app, and explored alcohol consumption and craving outcomes in people drinking at hazardous levels or above (Alcohol Use Disorders Identification Test [AUDIT] score ≥8) who wanted to reduce their alcohol use. In this open-label trial, frequency and quantity of alcohol consumption, alcohol dependence severity, and craving were measured prior to participants downloading SWiPE. Participants (n=1309) were instructed to complete at least 2 sessions per week for 4 weeks. Recruitment and completion rates were indicators of feasibility. Functionality, aesthetics, and quality ratings were indicators of acceptability. Participants were prompted to report frequency and quantity of alcohol consumption weekly during training and 1 month after training. They completed measures of craving and dependence after 4 weeks of training. We recruited 1309 participants (mean age 47.0, SD 10.0 years 758/1309, 57.9% female mean AUDIT score 21.8, SD 6.5) over 6 months. Participants completed a median of 5 sessions (IQR 2-9) 31.2% (409/1309) completed ≥8 sessions and 34.8% (455/1309) completed the posttraining survey. Mean Mobile Application Rating Scale scores indicated good acceptability for functionality and aesthetics and fair acceptability for subjective quality. Among those who completed the posttraining assessment, mean past-week drinking days reduced from 5.1 (SD 2.0) pre-training to 4.2 (SD 2.3) in week 4 (t454=7.87 P .001), and mean past-week standard drinks reduced from 32.8 (SD 22.1) to 24.7 (SD 20.1 t454=8.58 P .001). Mean Craving Experience Questionnaire frequency scores reduced from 4.5 (SD 2.0) to 2.8 (SD 1.8 t435=19.39 P .001). Severity of Dependence scores reduced from 7.7 (SD 3.0) to 6.0 (SD 3.2 t435=12.44 P .001). For the 19.4% (254/1309) of participants who completed a 1-month follow-up, mean past-week drinking days and standard drinks were 3.9 (SD 2.5) and 23.9 (SD 20.7), respectively, both significantly lower than at baseline (P .001). The findings suggest SWiPE is feasible and acceptable and may be effective at reducing alcohol consumption and craving in a predominantly nontreatment-seeking s le of adult Australians drinking at hazardous levels. SWiPE’s efficacy, relative to a control condition, now needs establishing in a randomized controlled trial. Smartphone-delivered personalized ApBM could be a highly scalable, widely accessible support tool for reducing alcohol use. Australian New Zealand Clinical Trials Registry ACTRN12620000638932 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000638932p RR2-10.2196/21278

Neurocognitive deficits, craving, and abstinence among alcohol-dependent individuals following detoxification

Publisher: Oxford University Press (OUP)

Date: 13-12-2014

DOI: 10.1093/ARCLIN/ACT090

Abstract: Alcohol dependence, a chronic relapsing disorder, is characterized by an impaired ability to regulate compulsive urges to consume alcohol. Very few empirical studies have examined the presence of these executive deficits, how they relate to craving, and the enduring nature of these deficits during abstinence. As such, the current study aimed to characterize these cognitive deficits within a s le of 24 alcohol-dependent participants post-detoxification and 23 non-alcohol-dependent participants. Participants were administered the Sustained Attention to Response Task to measure response inhibition and sustained attention and the Random Number Generation Task to examine executive deficits. Correlations between cognitive performance and clinical measures of alcohol dependence were examined. As predicted, the alcohol-dependent group exhibited poorer performance across the domains of response inhibition, executive function, and attentional control. Cognitive performance was related to clinical measures of craving and years of alcohol consumption, whereas the duration of abstinence was not associated with improved cognitive performance. These findings highlight the need for therapeutic strategies to target these enduring neurocognitive deficits in improving the treatment of alcohol dependence.

Subacute effects of ecstasy on mood: An exploration of associated risk factors

Publisher: SAGE Publications

Date: 24-10-2013

DOI: 10.1177/0269881112463467

Abstract: Ecstasy use may result in lowered mood, anxiety or aggression in the days following use. Yet, few studies have investigated what factors increase the risk of experiencing such symptoms. Ecstasy users (at least once in the last 12 months) who subsequently took ecstasy ( n=35) over the period of one week, were compared on measures of mood, sleep, stress and drug use, with those who abstained from ecstasy ( n=21) that week. Measures were administered the week prior to ecstasy use and one and three days following use, or the equivalent day for abstainers. Mood symptoms were assessed using the Kessler-10 self-report psychological distress scale, a subjective mood rating (1–10), and using the depression, anxiety and hostility items from the clinician-rated Brief Psychiatric Rating Scale. Timeline Followback methods were used to collect information on drug use and life stress in the past month. Self-reported sleep quality was also assessed. Ecstasy use was not associated with subacute depressive, anxiety or aggressive symptoms. Rather, lowered mood and increased psychological distress were associated with self-reported hours and quality of sleep obtained during the three-day follow-up. These findings highlight the importance of considering sleep disruption in understanding the short-term mood effects of ecstasy use.

The impact of substance use disorders on clinical outcome in 643 patients with first‐episode psychosis

Publisher: Wiley

Date: 26-04-2005

DOI: 10.1111/J.1600-0447.2005.00554.X

Abstract: Studies investigating the impact of comorbid substance use disorders (SUD) in psychosis have tended to focus on cross-sectional data, with few studies examining the effects of substance use course on clinical outcome. The main aim of the present study was to assess the impact of baseline SUD and course of SUD on remission of positive symptoms. The Early Psychosis Prevention and Intervention Centre admitted 786 first-episode psychosis (FEP) patients between 1998 and 2000. Data on SUD and clinical outcome were collected from patients' medical records (MR) of 643 patients who met inclusion criteria. Lifetime prevalence of SUD was 74%, with 62% having a SUD at baseline. This reduced to 36% in those patients who completed 18 months of treatment at the EPPIC program. A Cox regression analysis indicated that a decrease or cessation of substance use significantly increased the probability of remission, whilst persistent SUD substantially reduced the likelihood. In addition, patients who reduced use appeared to have better outcomes at 18 months than those patients who had never used substances. Baseline SUD was not found to have any significant influence on symptom remission. Patients presenting with FEP have high rates of SUD. Effective management of psychosis within a specialized service is associated with reductions in SUD over the course of treatment, although persistent substance use is associated with non-compliance, treatment drop-out and poor remission rates. As such, young people with FEP and comorbid substance use should be offered integrated treatment that addresses both disorders.

Putting out the welcome mat—A qualitative exploration of service delivery processes and procedures as barriers to treatment‐seeking for people who use alcohol and other drugs

Publisher: Wiley

Date: 28-09-2022

DOI: 10.1111/DAR.13551

Abstract: There are a range of models and structures that determine features of alcohol and other drug treatment. Despite some structures being long‐established, less is known about how specific aspects of service delivery impact treatment‐seeking for people who use alcohol and other drugs. This Australian qualitative study explored both people with lived experience of problematic alcohol and other drug use, and health care staff's experiences of service delivery. Thirty‐nine semi‐structured interviews with people with lived experience and staff from either alcohol and other drug specialist, or broader health‐care services, explored experiences of service delivery processes and procedures. Transcripts were thematically analysed and guided by a broad interest in barriers to treatment‐seeking. Within alcohol and other drug specialist services (i) time spent on wait lists and (ii) poor implementation of assessment processes were identified barriers to treatment‐seeking and engagement. Within broader health‐care services (i) organisational expectations around behaviour and engagement (ii) alcohol and other drugs viewed as separate to service role and (iii) limited opportunities to informally engage were identified barriers to treatment‐seeking. Results suggest opportunities to engage and undertake needs‐based care planning are yet to be fully realised, particularly at the intake and assessment stages of alcohol and other drug service delivery with frequent reassessment resulting in people repeatedly recounting traumatic experiences, often to different people, only to be placed back on wait lists with no support. Within broader health‐care services aspects of service delivery may perpetuate stigma that places such people outside the purview of health care.

Social networks and recovery (SONAR): characteristics of a longitudinal outcome study in five therapeutic communities in Australia

Publisher: Emerald

Date: 12-09-2016

DOI: 10.1108/TC-04-2016-0012

#WaysToRelax: Developing an online alcohol-related health promotion animation for people aged 55 and older

Publisher: The Sax Institute

Date: 2017

DOI: 10.17061/PHRP2721718

Abstract: Alcohol use among middle-aged and older adults (55 years and older) is increasingly becoming a public health concern. Despite this, there is relatively little research on the experiences of alcohol use and related concerns among people aged 55 and older to inform tailored and engaging health promotion activities. To address this gap, we aimed to develop an engaging alcohol-related health promotion resource for people aged 55 and older. We drew on a research-into-action approach, which involved: 1) thematic analysis of alcohol-related concerns in online counselling transcripts of 70 people aged 55 and older, 2) a review of health promotion literature, and 3) consultation with consumers of alcohol and other drug services, and carers. The research phase highlighted that people aged 55 and older were concerned that their reliance on alcohol use to manage stress had become a habit they wanted to shift. Alongside this, the literature showed that people aged 55 and older were often dismissive of conventional health promotion activities, and pointed to the benefits of conveying health promotion messages through animation. In response, we developed an animation to stimulate reflection and thought about other ways to relax and manage stress. We drew on health promotion principles to ensure that the animation had a positive message and was engaging without being ageist or paternalistic. It was further refined with input from consumers and carers, who thought the animation was appropriate, appealing and useful. Future activities will include further dissemination and evaluation of the animation and associated activities.

Obsessive compulsive disorder

Publisher: Psychology Press

Date: 14-04-0384

DOI: 10.4324/9781315692289

Diagnostic accuracy for self‐reported methamphetamine use versus oral fluid test as the reference standard in a methamphetamine‐dependent intervention trial population

Publisher: Wiley

Date: 03-12-2022

DOI: 10.1111/ADD.16085

Abstract: Treatment of meth hetamine dependence requires monitoring of recent use or abstinence. Self‐report is commonly used for routine monitoring, but the accuracy of self‐report is not established. For the treating clinician, the key accuracy statistic is the negative predictive value (NPV). The study aim was to estimate the NPV of self‐reported non‐use of meth hetamine compared with an oral fluid reference standard. This study was a secondary (subgroup) analysis from a randomized controlled pharmacotherapy trial. Three Australian outpatient addiction services took part. Particpants were 139 people dependent on meth hetamine. Weekly oral fluid s les over 12 weeks to determine meth hetamine (and hetamine) concentrations were used as the reference standard. Self‐report of any meth hetamine use in the previous 7 days by the time‐line follow‐back method was the index test. Standard diagnostic accuracy statistics were calculated for all available paired episodes ( n = 1134). Three NPV values were calculated: unadjusted NPV and NPV adjusted for clustering of observations through logistic regression and generalized estimating equation (GEE). We also calculated the NPVs for a range of prevalence rates of meth hetamine use, for the calculated levels of sensitivity and specificity. Sensitivity was 96.4% [95% confidence interval (CI) = 95–97.5], specificity was 63.7% (95% CI = 57.3–69.8) and positive predictive value (PPV) was 90.8% (95% CI = 88.8–92.6). The unadjusted NPV was 82.7% (95% CI = 76.5–87.9), adjusted NPV by logistic regression 82.7% (95% CI = 73.9–91.5) and GEE 76.8% (95% CI = 66.8–86.8). At a meth hetamine use prevalence of 5%, the estimated NPV would be 99.7% (95% CI = 99.6–99.9) and at 95% prevalence, 48.2% (95% CI = 39.6–57.0). Self‐report of no recent meth hetamine use appears to be sufficiently accurate to be clinically useful at the expected prevalence rates of meth hetamine use in clinical treatment settings. If generalizable to clinical settings, where these tests are routinely conducted, this may permit a reduction in the frequency and cost of oral fluid assays.

The National Ambulance Surveillance System: A novel method for monitoring acute alcohol, illicit and pharmaceutical drug related-harms using coded Australian ambulance clinical records

Publisher: Public Library of Science (PLoS)

Date: 31-01-2020

DOI: 10.1371/JOURNAL.PONE.0228316

Multiple Pathways to Recovery, Multiple Roads to Well-Being: An Analysis of Recovery Pathways in the Australian Life in Recovery Survey

Publisher: Informa UK Limited

Date: 18-07-2018

DOI: 10.1080/07347324.2018.1490158

Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

Publisher: Springer Science and Business Media LLC

Date: 08-2012

DOI: 10.1186/1471-244X-12-96

Brain Network Connectivity in Adolescents At Risk for Alcohol Use Problems

Publisher: Cold Spring Harbor Laboratory

Date: 27-10-2020

DOI: 10.1101/2020.10.22.20217976

Abstract: Imaging studies of young people with a family history of alcohol use disorder (AUD) have found structural and/or functional differences within and between anatomically distributed and functionally specialised systems throughout the brain. Differences in brain connectivity among adolescents with a family history of AUD may account for the increased risk of later alcohol use problems however, to date, no prospective studies have directly examined this hypothesis across the entire connectome in a regionally unbiased way. Our analysis included 52 adolescents ( M age = 16.5 years ± 0.6 SD ) assessed with diffusion-weighted magnetic resonance imaging, of whom 20 had a family history of AUD and 32 did not. All participants were followed-up 2.3 years later and completed a questionnaire measuring past year alcohol use and alcohol-related harms. Subject-specific connectomic maps of structural connectivity were constructed using two parcellation schemes (82-node anatomical and 530-node random) and five measures of connectivity weight (streamline count, fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity), and a connectome-wide network-based statistic analysis was used to compare group differences at each and every connection between adolescents with and without a family history of AUD. Baseline connectivity measures did not differentiate these groups, and we did not find an association between baseline connectivity measures and alcohol outcomes at follow-up. These findings suggest that atypical inter-regional structural connectivity may not contribute to the risk of developing alcohol use problems in this particular age group, or during this particular period of development.

Improved outcomes following contact with a gambling helpline: the impact of gender on barriers and facilitators

Publisher: Informa UK Limited

Date: 04-05-2014

DOI: 10.1080/14459795.2014.921721

The role of methamphetamines in psychosis-related ambulance presentations

Publisher: SAGE Publications

Date: 07-05-2015

DOI: 10.1177/0004867415585323

Adolescent toluene inhalation in rats affects white matter maturation with the potential for recovery following abstinence.

Publisher: Public Library of Science (PLoS)

Date: 18-09-2012

DOI: 10.1371/JOURNAL.PONE.0044790

Clinician and patient barriers to the recognition of insomnia in family practice: a narrative summary of reported literature analysed using the theoretical domains framework

Publisher: Springer Science and Business Media LLC

Date: 04-01-2020

DOI: 10.1186/S12875-019-1070-0

Abstract: Insomnia is a common sleep complaint, with 10% of adults in the general population experiencing insomnia disorder, defined as lasting longer than three months in DSM-5. Up to 50% of patients attending family practice experience insomnia, however despite this, symptoms of insomnia are not often screened for, or discussed within this setting. We aimed to examine barriers to the assessment and diagnosis of insomnia in family practice from both the clinician and patient perspective. The present article identified research that has examined barriers to assessing insomnia from the clinician’s and the client’s perspectives following MEDLINE and Google Scholar searches, and then classified these barriers using the theoretical domains framework. The most common barriers from the clinician’s perspective were related to Knowledge, Skills, and the Environmental Context. From the patient perspective, barriers identified included their Beliefs about the consequences of Insomnia, Social Influences, and Behavioural Regulation of Symptoms. Utilising this theoretical framework, we discuss options for bridging the gap between the identification and subsequent management of insomnia within the family practice setting. To assist clinicians and those in community health care to overcome the Knowledge and Skills barriers identified, this article provides existing relevant clinical criteria that can be utilised to make a valid diagnosis of insomnia.

Time to address addiction treatment inequality in hospital settings

Publisher: Elsevier BV

Date: 2022

DOI: 10.1016/S2468-2667(21)00260-7

Developing integrated models of care within the youth Alcohol and Other Drug sector

Publisher: SAGE Publications

Date: 2008

DOI: 10.1080/10398560802027294

Abstract: Objective: The aim of this paper is to describe an initiative in Victoria, Australia, aimed at improving the detection and management of co-occurring mental health issues within the youth Alcohol and Other Drug (AOD) sector. Conclusions: Over the past 4 years, in partnership with local youth AOD services, we have developed a successful service model that addresses co-occurring mental health issues within the youth AOD sector. However, such capacity-building requires the full support of workers and senior management, and a cultural shift whereby the assessment and management of mental health issues are seen as a priority and core service issue. The capacity-building process was facilitated by embedding experienced mental health clinicians within each service to support and implement the initiative. This model offered learning opportunities through the modelling of relevant skills and the provision of ‘on-the-job’ training. Such approaches demonstrate that integrated models of care can be delivered within youth AOD services, although further research is needed to determine their effectiveness.

The Australian drug harms ranking study

Publisher: SAGE Publications

Date: 13-05-2019

DOI: 10.1177/0269881119841569

Abstract: The aim of the current study was to review drug harms as they occur in Australia using the Multi-criteria Decision Analysis (MCDA) methodology adopted in earlier studies in other jurisdictions. A facilitated workshop with 25 experts from across Australia, was held to score 22 drugs on 16 criteria: 9 related to harms that a drug produces in the in idual and 7 to harms to others. Participants were guided by facilitators through the methodology and principles of MCDA. In open discussion, each drug was scored on each criterion. The criteria were then weighted using a process of swing weighting. Scoring was captured in MCDA software tool. MCDA modelling showed the most harmful substances to users were fentanyls (part score 50), heroin (part score 45) and crystal meth hetamine (part score 42). The most harmful substances to others were alcohol (part score 41), crystal meth hetamine (part score 24) and cigarettes/tobacco (part score 14). Overall, alcohol was the most harmful drug when harm to users and harm to others was combined. A supplementary analysis took into consideration the prevalence of each substance in Australia. Alcohol was again ranked the most harmful substance overall, followed by cigarettes, crystal meth hetamine, cannabis, heroin and pharmaceutical opioids. The results of this study make an important contribution to the emerging international picture of drug harms. They highlight the persistent and pervasive harms caused by alcohol. Policy implications and recommendations are discussed. Policies to reduce harm from alcohol and meth hetamine should be a priority.

The Impact of Regular Cannabis Use on the Human Brain: A Review of Structural Neuroimaging Studies

Publisher: Elsevier

Date: 2013

DOI: 10.1016/B978-0-12-398335-0.00069-8

Understanding drug addiction: A neuropsychological perspective

Publisher: SAGE Publications

Date: 12-2007

DOI: 10.1080/00048670701689444

Abstract: The purpose of the present review is to describe the neuropsychological correlates of long-term substance abuse and to discuss the findings within the context of premorbid vulnerabilities, comorbidity and adolescent neurodevelopment. The authors critically review key findings from the neuropsychological literature related to the long-term sequelae of alcohol, cannabis, inhalant, opiates, psychostimulants and ecstasy use. Leading electronic databases such as PubMed were searched to identify relevant studies published in the past 20 years. References identified from bibliographies of pertinent articles and books in the field were also collected and selectively reviewed. Across substances, in iduals with long-term abuse consistently demonstrate neuropsychological impairments of executive (inhibitory) control, working memory and decision making, together with neurobiological abnormalities involving frontotemporal and basal ganglia circuits. In some instances these deficits are dose dependent, implying that they are a direct consequence of prolonged drug exposure. However, comorbid behavioural, personality and mental health problems are common among drug-using populations and are associated with similar neuropsychological deficits. Presented herein is a neuropsychological model of addictive behaviour that highlights the complex interplay between cognition, brain maturation, psychopathology and drug exposure.

Pharmaceutical opioid overdose deaths and the presence of witnesses

Publisher: Elsevier BV

Date: 05-2018

DOI: 10.1016/J.DRUGPO.2017.12.020

Abstract: In the past two decades, rates of pharmaceutical opioid use and harms resulting from their use (including death) have risen. The present study identified a series of fatal opioid overdoses where there was evidence that witnesses had noted symptoms consistent with overdose, and examined associated contextual factors. A retrospective review was undertaken utilising the Coroners Court of Victoria's Overdose Deaths Register for pharmaceutical opioid overdose deaths between 2011 and 2013. Information on the source of pharmaceutical opioids, co-contributing drugs, history of drug dependence, and mental illness was extracted and coded. Pharmaceutical opioids were involved in 587 deaths, and within these, 125 cases (21%) were witnessed. The majority of these witnessed deaths (77.6%) occurred at the deceased's residence, with the witness being a partner or unrelated acquaintance who did not realise the significance of what they were witnessing. The most common contributing pharmaceutical opioids were methadone (49.6%), codeine (32.0%), and oxycodone (19.2%), with the source more often prescribed than erted. Co-contributing drugs were involved in 110 cases, with the most common being benzodiazepines. Evidence of current dependence and mental illness was found in 53.6% of cases. Most pharmaceutical opioid overdose deaths with a witness present occurred in the deceased's home, with symptoms of overdose being noted, but not acted upon. These findings support the trialling of education and/or naloxone to partners and family members of people who use pharmaceutical opioids in order to reduce overdose deaths.

The Methamphetamine-Associated Psychosis Spectrum: a Clinically Focused Review

Publisher: Springer Science and Business Media LLC

Date: 21-05-2018

DOI: 10.1007/S11469-018-9934-4

Timing of Health Service Use Among Truck Drivers After a Work-Related Injury or Illness

Publisher: Springer Science and Business Media LLC

Date: 08-09-2021

DOI: 10.1007/S10926-021-10001-Y

Abstract: Purposes Timely delivery of treatment and rehabilitation is generally acknowledged to support injury recovery. This study aimed to describe the timing of health service use by injured truck drivers with work-related injury and to explore the association between demographic and injury factors and the duration of health service use. Methods Retrospective cohort study of injured truck drivers with accepted workers’ compensation claims in the state of Victoria, Australia. Descriptive analyses examined the percentage of injured truck drivers using health services by service type. Logistic regression model examined predictors of any service use versus no service use, and predictors of extended service use (≥ 52 weeks) versus short-term use. Results The timing of health service use by injured truck drivers with accepted workers’ compensation claims varies substantially by service type. General practitioner, specialist physician, and physical therapy service use peaks within the 14 weeks after compensation claim lodgement, whilst the majority of mental health services were accessed in the persistent phase beyond 14 weeks after claim lodgement. Older age, being employed by small companies, and claiming compensation for mental health conditions were associated with greater duration of health service use. Conclusions Injured truck drivers access a wide range of health services during the recovery and return to work process. Delivery of mental health services is delayed, including for those making mental health compensation claims. Health service planning should take into account worker and employer characteristics in addition to injury type.

Synthetic cannabinoid use disorder: an update for general psychiatrists

Publisher: SAGE Publications

Date: 21-01-2019

DOI: 10.1177/1039856218822749

Abstract: Synthetic cannabinoid use disorder is emerging as a significant clinical issue. This article provides the general psychiatrist with an overview of the physical and psychiatric adverse effects of chronic synthetic cannabinoid use, as well as specific clinical responses. We performed electronic searches of Ovid MEDLINE and Ovid Embase to identify key articles, of all methodological designs, published up to June 2018. The available evidence suggests that, compared to cannabis, use of synthetic cannabinoids is associated with the more rapid development of dependence, increased psychiatric risks and complex withdrawal, and serious physical adverse effects that include seizures, cardiotoxicity and death, denoting a potential need for more intensive management. When synthetic cannabinoid use is identified, along with management of acute physical and psychiatric adverse effects, psychotherapeutic strategies to reduce use and/or harm are recommended.

The assessment and management of gamma hydroxybutyrate use in general practice

Publisher: The Royal Australian College of General Practitioners

Date: 2020

DOI: 10.31128/AJGP-05-19-4953

Cognitive insight, medication adherence and methamphetamine cessation in people enrolled in a pharmacotherapy trial for methamphetamine use

Publisher: Elsevier BV

Date: 11-2021

DOI: 10.1016/J.JSAT.2021.108473

Social and transitional identity: exploring social networks and their significance in a therapeutic community setting

Publisher: Emerald

Date: 08-04-2014

DOI: 10.1108/TC-04-2013-0007

Abstract: – There is considerable literature indicating the importance of social connectedness and its relationship to wellbeing. For problem substance users, a similar literature emphasises the importance of the transition from a social network supportive of use to one that fosters recovery. Within this framework, the therapeutic community (TC) is seen as a critical location for adopting a transitional identity (i.e. from a “drug user” to a “member of the TC”), as part of the emergence of a “recovery identity” following treatment. The purpose of this paper is to outline a model for conceptualising and measuring identity based on the theories of social identity and recovery capital, and pilots this model within a TC setting. – A social identity mapping was used with TC residents to test their identification with “using” and “TC” groups, and their relationship to recovery capital. – The network mapping method was acceptable to TC residents, and provided valuable insights into the social networks and social identity of TC residents. – This paper explores issues around mapping social identity and its potential in the TC and other residential settings. – The paper integrates a number of conceptual models to create a new framework for understanding transitions in social networks during treatment and reports on a novel measurement method underpinning this.

A signal detection analysis of executive control performance among adolescent inhalant and cannabis users

Publisher: Informa UK Limited

Date: 06-08-2014

DOI: 10.3109/10826084.2014.935793

Abstract: Inhalant users have multiple comorbid issues (e.g., polydrug use) that complicate identifying inhalant-specific cognitive deficits. The aim of the present study was to use signal detection theory to identify inhalant-specific differences in executive control. We examined three well-matched groups: 19 inhalant users, 19 cannabis users, and 19 controls using Stroop and Go/No-Go tasks. Inhalant users demonstrated significantly lower d-prime scores relative to controls, but not cannabis users, on both tasks, suggesting possible executive deficits relative to controls. CONCLUSIONS/IMPORTANCE: The results of this study raise questions regarding inhalant toxicity and the vulnerability of the adolescent brain to drugs of abuse.

From eye rolls to punches: experiences of harm from others' drinking among risky-drinking adolescents across Australia

Publisher: The Sax Institute

Date: 12-2019

DOI: 10.17061/PHRP2941927

Abstract: Exploration of experience of harms due to another person's drinking within a demographic particularly vulnerable to these consequences. Importance of study: Largest s ling of young Australian risky drinkers, who are underrepresented in general population surveys. The range of harms due to others' drinking reported here is more comprehensive than documented elsewhere. Cross-sectional self-report survey. Participants were 14-19 years old and screened as being within the riskiest-drinking 25% for their age cohort. The convenience s le of 3465 was recruited primarily by social media advertising. Face-to-face interviews were conducted in all eight Australian capital cities (n = 596), supplemented by online surveys (n = 2869). Past 12-month experience of 13 harms due to others' drinking was assessed by age, gender and perpetrator. Females were more likely to experience seven harms, mainly characterised by fear and harassment, including being harassed or bothered at a party or some other private setting (41% vs 34% of males, p < 0.001), being given unwanted sexual attention (71% vs 47%, p < 0.001) and being put in fear (33% vs 20%, p < 0.001). Males were more likely to experience three harms, characterised by aggression: being yelled at, criticised or verbally abused (38% vs 33% of females, p = 0.002), being pushed or shoved (42% vs 28%, p < 0.001) and being physically hurt (17% vs 11%, p < 0.001). Teenagers of a legal alcohol-purchase age were more likely to experience harassment in public settings (49% vs 32-34%, p < 0.001) and unwanted sexual attention (66% vs 51-59%, p < 0.001) compared with younger teenagers. Seven of the harms studied were more likely (p < 0.01) to be perpetrated by people the respondents knew, and five (those associated with fear and aggression) were more likely to be perpetrated by strangers. Young people who are risky drinkers commonly experience multiple harms from others' drinking. Many of these alcohol harms to others are reported here for the first time, as previous studies of adolescent drinking have focused almost exclusively on the harms young people have experienced from their own drinking. This refocusing on the harms caused by the drinking of others may prompt greater community concern and concomitant calls for better alcohol regulation.

Improving help-seeking among adolescents: A school-based intervention

Publisher: SAGE Publications

Date: 17-12-2015

DOI: 10.1177/0004867415598847

Changes in alcohol intoxication-related ambulance attendances during COVID-19: How have government announcements and policies affected ambulance call outs?

Publisher: Elsevier BV

Date: 09-2021

DOI: 10.1016/J.LANWPC.2021.100222

Integrated care – panacea or white elephant? A review of integrated care approaches in Australia over the past two decades

Publisher: Emerald

Date: 26-01-2023

DOI: 10.1108/ADD-10-2022-0026

Abstract: Integrated care is widely supported as a means of improving treatment outcomes for people with co-occurring mental health and substance use disorders. Over the past two decades, Australian state and federal governments have identified integrated care as a policy priority and invested in a number of research and capacity building initiatives. This study aims to examine Australian research evaluating the effectiveness of integrated treatment approaches to provide insight into implications for future research and practice in integrated treatment. This narrative review examines Australian research evaluating empirical evidence of the effectiveness of integrated treatment approaches within specific populations and evidence from initiatives aimed at integrating care at the service or system level. Research conducted within the Australian context provides considerable evidence to support the effectiveness of integrated approaches to treatment, particularly for people with high prevalence co-occurring disorders or symptoms of these (i.e. anxiety and depression). These have been delivered through various modalities (including online and telephone-based services) to improve health outcomes in a range of populations. However, there is less evidence regarding the effectiveness of specific models or systems of integrated care, including for more severe mental disorders. Despite ongoing efforts on behalf of the Australian government, attempts to sustain system-level initiatives have remained h ered by structural barriers. Effective integrated interventions can be delivered by trained clinicians without requiring integration at an organisational or structural level. While there is still considerable work to be done in terms of building sustainable models at a system level, this evidence provides a potential foundation for the development of integrated care models that can be delivered as part of routine practice.

Volumetric differences in the anterior cingulate cortex prospectively predict alcohol-related problems in adolescence

Publisher: Springer Science and Business Media LLC

Date: 20-02-2014

DOI: 10.1007/S00213-014-3483-8

Abstract: In idual differences in brain structure and function are suggested to exist prior to the onset of alcohol abuse. Cross-sectional studies have demonstrated abnormalities in brain regions underlying affective processes that may form a pathway to the emergence of later alcohol abuse and dependence in vulnerable in iduals. However, no prospective studies have examined whether these abnormalities predict later problems with alcohol. This study aims to examine whether in idual differences in affect and brain volume prospectively predict alcohol-related problems in adolescence. Adolescent drinkers (n = 98) were recruited from an ongoing prospective, longitudinal study examining adolescent emotional development. At age 12, participants underwent structural magnetic resonance imaging to obtain volumetric data on the amygdala, hippoc us, orbitofrontal cortex, and anterior cingulate cortex (ACC), and completed a self-report measure of affective temperament. At age 16, participants completed a questionnaire measuring alcohol use, with 39 % reporting alcohol-related problems in the past year. Pre-existing differences in the left ACC predicted problem drinking. Alcohol-related problems were associated with higher levels of temperamental negative affectivity however, these were not correlated with anterior cingulate volumes. These findings indicate that in idual differences in the structural morphology of the anterior cingulate, a region implicated in affective processes, self-control, and drug addiction, predict later alcohol-related problems. Although this finding remained significant after controlling for other substance use and psychopathology, future research is required to test its specificity for alcohol use disorders.

More Australian research needed into alcohol and energy drinks

Publisher: Wiley

Date: 18-06-2012

DOI: 10.1111/J.1465-3362.2012.00483.X

Quik fix: A randomized controlled trial of an enhanced brief motivational interviewing intervention for alcohol/cannabis and psychological distress in young people

Publisher: S. Karger AG

Date: 22-12-2013

DOI: 10.1159/000341921

Types of change strategies for limiting or reducing gambling behaviors and their perceived helpfulness: A factor analysis.

Publisher: American Psychological Association (APA)

Date: 09-2018

DOI: 10.1037/ADB0000393

Abstract: Gamblers engage with a broad range of resources and strategies to limit or reduce their gambling. However, there is limited research examining the uptake and helpfulness of the full range of strategies gamblers employ. The aim of this study was to compile a comprehensive inventory of change strategies and then group these using principal component analysis based on perceived helpfulness. We also aimed to determine whether there are differences in the helpfulness of strategies by demographic, gambling severity, and readiness indicators. The Change Strategies Questionnaire-Version 1 contained 99 strategies, and 489 gamblers (including 333 problem gamblers) identified the most frequently endorsed strategy as remind yourself of negative consequences of gambling (92%) and think about how money could be better spent (92%). Principal components analysis identified 15 strategy groupings: cognitive, well-being, consumption control, behavioral substitution, financial management, urge management, self-monitoring, information seeking, spiritual, avoidance, social support, exclusion, planning, feedback, and limit finances. There were differences in the helpfulness of strategies by age and gambling severity. Few strategies were correlated with confidence to manage an urge to gamble. Overall, change strategies were viewed as moderately helpful. The top five strategies were all used by at least 90% of gamblers, and these strategies were all cognitive in nature. This study provides important information for the development of interventions targeting gambling behavior. Furthermore, it suggests that interventions for problem gambling should target cognitive, feedback, planning, and urge management strategies. (PsycINFO Database Record

The six Rs of managing high-risk opioid prescribing

Publisher: The Royal Australian College of General Practitioners

Date: 03-2020

DOI: 10.31128/AJGP-06-19-4967

Social identity, social networks and recovery capital in emerging adulthood: A pilot study

Publisher: Springer Science and Business Media LLC

Date: 11-11-2015

DOI: 10.1186/S13011-015-0041-2

A Personalized Approach Bias Modification Smartphone App (“SWiPE”) to Reduce Alcohol Use: Open-Label Feasibility, Acceptability, and Preliminary Effectiveness Study (Preprint)

Publisher: JMIR Publications Inc.

Date: 18-06-2021

DOI: 10.2196/PREPRINTS.31353

Abstract: pproach bias modification (ApBM), a computerized cognitive intervention that trains people to “avoid” alcohol-related images and “approach” nonalcohol images, reduces the likelihood of relapse when administered during residential alcohol treatment. However, most in iduals experiencing alcohol problems do not require, do not seek, or have difficulty accessing residential treatment. Smartphone-delivered ApBM could offer an easily accessible intervention to reduce alcohol consumption that can be personalized (eg, allowing selection of personally relevant alcohol and positive nonalcohol training images) and gamified to optimize engagement. e examined the feasibility, acceptability, and preliminary effectiveness of “SWiPE,” a gamified, personalized alcohol ApBM smartphone app, and explored alcohol consumption and craving outcomes in people drinking at hazardous levels or above (Alcohol Use Disorders Identification Test [AUDIT] score ≥8) who wanted to reduce their alcohol use. n this open-label trial, frequency and quantity of alcohol consumption, alcohol dependence severity, and craving were measured prior to participants downloading SWiPE. Participants (n=1309) were instructed to complete at least 2 sessions per week for 4 weeks. Recruitment and completion rates were indicators of feasibility. Functionality, aesthetics, and quality ratings were indicators of acceptability. Participants were prompted to report frequency and quantity of alcohol consumption weekly during training and 1 month after training. They completed measures of craving and dependence after 4 weeks of training. e recruited 1309 participants (mean age 47.0, SD 10.0 years 758/1309, 57.9% female mean AUDIT score 21.8, SD 6.5) over 6 months. Participants completed a median of 5 sessions (IQR 2-9) 31.2% (409/1309) completed ≥8 sessions and 34.8% (455/1309) completed the posttraining survey. Mean Mobile Application Rating Scale scores indicated good acceptability for functionality and aesthetics and fair acceptability for subjective quality. Among those who completed the posttraining assessment, mean past-week drinking days reduced from 5.1 (SD 2.0) pre-training to 4.2 (SD 2.3) in week 4 ( i t /i sub /sub =7.87 i P /i & .001), and mean past-week standard drinks reduced from 32.8 (SD 22.1) to 24.7 (SD 20.1 i t /i sub /sub =8.58 i P /i & .001). Mean Craving Experience Questionnaire frequency scores reduced from 4.5 (SD 2.0) to 2.8 (SD 1.8 i t /i sub /sub =19.39 i P /i & .001). Severity of Dependence scores reduced from 7.7 (SD 3.0) to 6.0 (SD 3.2 i t /i sub /sub =12.44 i P /i & .001). For the 19.4% (254/1309) of participants who completed a 1-month follow-up, mean past-week drinking days and standard drinks were 3.9 (SD 2.5) and 23.9 (SD 20.7), respectively, both significantly lower than at baseline ( i P /i & .001). he findings suggest SWiPE is feasible and acceptable and may be effective at reducing alcohol consumption and craving in a predominantly nontreatment-seeking s le of adult Australians drinking at hazardous levels. SWiPE’s efficacy, relative to a control condition, now needs establishing in a randomized controlled trial. Smartphone-delivered personalized ApBM could be a highly scalable, widely accessible support tool for reducing alcohol use. ustralian New Zealand Clinical Trials Registry ACTRN12620000638932 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000638932p R2-10.2196/21278

Characterisation of presentations to a community‐based specialist addiction neuropsychology service: Cognitive profiles, diagnoses and comorbidities

Publisher: Wiley

Date: 12-08-2021

DOI: 10.1111/DAR.13135

Pharmacotherapy for co-occurring alcohol and drug disorders in schizophrenia and bipolar disorder: where is the evidence?

Publisher: Cambridge University Press (CUP)

Date: 04-2010

DOI: 10.1111/J.1601-5215.2010.00446.X

A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine

Publisher: Frontiers Media SA

Date: 23-12-2019

DOI: 10.3389/FPSYT.2019.00877

Development of Goal Management Training⁺ for Methamphetamine Use Disorder Through Collaborative Design

Publisher: Frontiers Media SA

Date: 25-04-2022

DOI: 10.3389/FPSYT.2022.876018

Abstract: Meth hetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes including earlier drop out and relapse. However, current treatments for MUD do not address executive functions. Goal Management Training (GMT) is an evidence-based cognitive remediation program for executive dysfunction, although required modifications to enhance its relevance and application within addiction treatment settings. This study aimed to (1) tailor GMT to the key cognitive deficits and typical treatment duration of MUD (2) explore consumers' (people with MUD) engagement with the revised program (3) implement a prototype of the program with consumers and (4) present the manualized standard administration to clinical service providers. We followed the Medical Research Council Complex Interventions Framework and employed an evidence- and person-based intervention development process. We used a four-phased approach and collaborated with neuropsychology experts, design researchers in healthcare, consumers with MUD, and clinical service providers. Each aim was addressed in a separate study phase including content refinement and review with neuropsychology experts (phase 1), intervention design and collaboration with consumers (phase 2), prototype development and review with consumers (phase 3), and final program modifications and review with clinical stakeholders (phase 4). Findings from phase 1 indicated support for targeting four cognitive processes (attention, impulse control, goal setting, and decision-making). Key feedback included the need to help habitualize cognitive strategies and to guide consumers in applying these strategies in emotionally salient situations. Findings from phases 2 and 3 indicated consumer support for the program strategies and materials but highlighted the need to further enhance the personal relevance of specific content and journal activities. Findings from phase 4 provided clinicians support for the revised program but indicated an opportunity to minimize unintended effects. We present the intervention materials for the final revised program, Goal Management Training + (GMT + ), in line with TIDieR guidelines. GMT + targets key cognitive processes and is sensitive to the clinical needs of people with MUD. Our intervention development process was important for informing the active ingredients and materials for GMT + , and indicated initial consumer and provider acceptability prior to conducting a clinical trial.

Ready to Change: A scheduled telephone counselling programme for problem gambling

Publisher: SAGE Publications

Date: 05-07-2012

DOI: 10.1177/1039856212449671

Abstract: This study describes the implementation of an innovative 4–6 week cognitive behavioural therapy (CBT) programme for problem gambling, Ready to Change (RTC), delivered via telephone and workbook. Participants referred into the programme during the first three years of operation had a mean age of 45 years (range 19–81 years). The majority of participants were female (56%, n=129) and had problems associated with gaming machines (81.7%, n=188). Between January 2008 and December 2010, 230 people were assessed and offered the RTC programme. The main reason for referral of a person into the programme was difficulty in accessing a face-to-face agency. We describe the components and challenges of a 4–6 week programme for the treatment of problem gambling delivered via telephone. While distance-based treatments address concerns over access to services, further research investigating their effectiveness is required.

‘Holding on’ and ‘letting go’: a thematic analysis of Australian parent’s styles of coping with their adult child’s methamphetamine use

Publisher: Informa UK Limited

Date: 31-08-2019

DOI: 10.1080/16066359.2019.1655547

Dynamic associations between opioid use and anhedonia: A longitudinal study in opioid dependence

Publisher: SAGE Publications

Date: 21-08-2018

DOI: 10.1177/0269881118791741

Abstract: Anhedonia is a commonly reported symptom among substance-dependent populations that appears to diminish with sustained abstinence. However, previous research has not determined whether anhedonia is dynamically linked to changing patterns of drug use, nor whether it predicts subsequent drug use. We aimed to test whether changes in illicit opioid use would predict changes in anhedonia, and whether increases in anhedonia would predict further opioid use. We conducted a longitudinal, observational study, with a convenience s le of 121 participants with current or past-year Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR) opioid dependence recruited from substance use treatment and related services and from pharmacies administering opioid substitution pharmacotherapy. Anhedonia was assessed with the Temporal Experience of Pleasure Scale and frequency of illicit opioid use was assessed using timeline follow-back interviews. There was a significant within-subject effect (β=−0.015 95% CI −0.02 to −0.01 p=0.001), indicating that participants’ Temporal Experience of Pleasure Scale scores typically declined (i.e. anhedonia increased) following a month with above-average opioid use and Temporal Experience of Pleasure Scale scores rose (i.e. anhedonia reduced) following a month with below-average opioid use. However, Temporal Experience of Pleasure Scale scores did not significantly predict opioid use in the subsequent month (β=−0.04, 95% CI −0.20 to 0.12 p=0.651). Changes in illicit opioid use predict self-reported anhedonia, suggesting a possible causal relationship whereby anhedonia is likely to worsen with frequent drug use and diminish with prolonged abstinence. However, anhedonia does not appear to drive further drug use.

Influence of formal and informal stakeholder relationship on megaproject performance: a case of China

Publisher: Emerald

Date: 12-05-2020

DOI: 10.1108/ECAM-07-2019-0353

Abstract: The purpose of this research is to seek better relational strategies between formal and informal stakeholder relationships to improve megaproject performance. The conceptual model was developed with twenty hypotheses based on the literature review. Then a questionnaire survey was conducted, and the collected data were analyzed by Partial Least squares Structural Equation Modeling (PLS-SEM) for validating the proposed model. Finally, the findings were discussed by a comparative study to explain the different effects of the formal and informal relationship on megaproject performance, and the managerial implications are presented for the stakeholders to implement the relationship management in the megaprojects. The research finding reveals that formal relationship plays a dominating role in cost, quality, and labor protection meanwhile, it is still more reliable in improving coordination, safety and environmental protection. Both formal and informal relationship is equally important towards collaboration and scheduling while the informal relationship is more effective in communication and project transparency. The study extends the knowledge of relationship management in the domain of the megaproject performance. It provides a comprehensive and systematic understanding of the impact of formal and informal stakeholder relationships on ten aspects of the megaproject performance by the proposed conceptual model and PLS-SEM results. The research findings contribute to the theory of relationship management on how the different influences between formal and informal stakeholder relationships lead to better megaproject performance from inter-organizational level to project and societal level.

Sleep- and Wake-Promoting Drugs: Where Are They Being Sourced, and What Is Their Impact?

Publisher: Informa UK Limited

Date: 08-07-2019

DOI: 10.1080/10826084.2019.1609040

Substance misuse in first-episode psychosis

Publisher: Cambridge University Press

Date: 19-02-2009

DOI: 10.1017/CBO9780511576287.015

Economic evaluations of alcohol pharmacotherapy: Systematic review of economic evaluations of pharmacotherapy for the treatment of alcohol use disorder

Publisher: SAGE Publications

Date: 12-10-2023

DOI: 10.1177/00048674231201541

National Ambulance Surveillance System: A novel method using coded Australian ambulance clinical records to monitor self-harm and mental health-related morbidity

Publisher: Public Library of Science (PLoS)

Date: 31-07-2020

DOI: 10.1371/JOURNAL.PONE.0236344

Patient-Reported Outcomes of Treatment of Opioid Dependence With Weekly and Monthly Subcutaneous Depot vs Daily Sublingual Buprenorphine

Publisher: American Medical Association (AMA)

Date: 10-05-2021

DOI: 10.1001/JAMANETWORKOPEN.2021.9041

A Brief Intervention for Improving Alcohol Literacy and Addressing Harmful Alcohol Use Among Women Attending an Australian Breast Screening Service (Health4her): Protocol for a Hybrid Effectiveness-Implementation Trial

Publisher: JMIR Publications Inc.

Date: 02-04-2014

DOI: 10.2196/44867

Abstract: Alcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumption. A breast screening service is a novel health care setting for brief alcohol intervention, with the potential for extensive reach. This study aimed to conduct a formative evaluation with breast screening service consumers to understand the need for, and acceptability of, brief alcohol intervention in the breast screening setting and collaboratively design a brief alcohol intervention (Health4Her) to test the effectiveness of Health4Her in improving knowledge of alcohol as a breast cancer risk factor (primary outcome), improving alcohol literacy, and reducing consumption among women attending a breast screening service and to examine the implementation strategy through process evaluation. This was a hybrid type II effectiveness-implementation trial comprising a randomized controlled trial (RCT) alongside a mixed methods program evaluation guided by applicable elements of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and Consolidated Framework for Implementation Research. Formative evaluation comprised a retrospective analysis of alcohol consumption data (n=49,240), a web-based survey (n=391), and focus groups and interviews (n=31) with breast screening service consumers. Women attending routine mammography, drinking at any level, were recruited to the single-site, double-blind RCT (n=558), and completed a baseline assessment before randomization (1:1) to receive Health4Her (alcohol brief intervention + lifestyle information) or control (lifestyle information) via animation on an iPad. Follow-up assessments were performed 4 and 12 weeks after randomization. The process evaluation included evaluation of trial administrative data, participant quantitative (n=497) and qualitative feedback (n=30), and site staff qualitative feedback (n=11). This research was funded in March and May 2019. Data collection for the formative evaluation and trial recruitment occurred between January and April 2020 and February and August 2021, respectively, with finalization of follow-up data collection in December 2021. Quantitative process evaluation data were collected during trial implementation, and collection of participant and staff feedback was finalized in December 2021. Results of the retrospective analysis of alcohol consumption data from breast screening service consumers is anticipated to be published in March 2023 and the results of the RCT to be published in March 2023. This study is anticipated to generate new substantial knowledge on the alcohol consumption and literacy needs of women attending breast screening and the extent to which these can be addressed using a novel, tailored brief alcohol intervention. The study design permits the evaluation of the effectiveness and implementation of Health4Her to predict and facilitate uptake in breast screening services. ClinicalTrials.gov NCT04715516 t2/show/NCT04715516 RR1-10.2196/44867

Evidence that anhedonia is a symptom of opioid dependence associated with recent use

Publisher: Elsevier BV

Date: 08-2017

DOI: 10.1016/J.DRUGALCDEP.2017.03.012

Abstract: Anhedonia is prevalent among substance-dependent populations. The hedonic allostasis model suggests this is due to the effects of addictive substances on neural substrates of reward processing. However, previous research may have been confounded by other factors likely to influence anhedonia, including tobacco use, psychopathology, and history of trauma and other stressors. Thus it remains unclear whether elevated anhedonia in substance-dependent populations is caused by substance use itself, or is due to other correlates of substance dependence. Multivariate analysis of covariance was conducted to test whether opioid-dependent participants' anhedonia scores were elevated, relative to a non-dependent control group, after controlling for psychosocial factors likely to influence anhedonia. Correlational analyses within opioid-dependent participants were also conducted to examine whether anhedonia was associated with recent illicit opioid use or duration of abstinence. There was a modest, but significant, elevation in anhedonia in opioid-dependent participants, relative to controls (Partial η These findings support the hypothesis that use of opioids can cause anhedonia, although other psychosocial factors may also contribute to the high prevalence of anhedonia among opioid-dependent populations.

A Latent Class Analysis of Perceived Barriers to Help-seeking among People with Alcohol Use Problems Presenting for Telephone-delivered Treatment

Publisher: Oxford University Press (OUP)

Date: 30-11-2023

DOI: 10.1093/ALCALC/AGAC063

Abstract: Despite the magnitude of alcohol use problems globally, treatment uptake remains low. This study sought to determine the proportion of people presenting to telephone-delivered alcohol treatment who are first-time help-seekers, and explored perceived barriers to help-seeking to understand the barriers this format of treatment may help to address. Secondary analysis of baseline data from a randomized controlled trial of a telephone-delivered intervention for alcohol use problems. Latent class analysis (LCA) identified participant profiles according to self-reported barriers to alcohol treatment. Participants’ (344) mean age was 39.86 years (SD = 11.36, 18–73 years) 51.45% were male. Despite high alcohol problem severity (Alcohol Use Disorder Identification Test: mean = 21.54, SD = 6.30 63.37% probable dependence), multiple barriers to accessing treatment were endorsed (mean = 5.64, SD = 2.41), and fewer than one-third (29.36%) had previously accessed treatment. LCA revealed a two-class model: a ‘low problem recognition’ class (43.32%) endorsed readiness-for-change and attitudinal barriers a ‘complex barriers’ class (56.68%) endorsed stigma, structural, attitudinal and readiness-to-change barriers, with complex barrier class membership predicted by female sex (adjusted OR = 0.45, 95% CI 0.28, 0.72) and higher psychological distress (adjusted OR = 1.13, 95% CI 1.08, 1.18). The majority of people accessing this telephone-delivered intervention were new to treatment, yet had high alcohol problem severity. Two distinct profiles emerged, for which telephone interventions may overcome barriers to care and tailored approaches should be explored (e.g. increasing problem awareness, reducing psychological distress). Public health strategies to address stigma, and raise awareness about the low levels of drinking that constitute problem alcohol use, are needed to increase help-seeking.

Developmental changes in brain network hub connectivity in late adolescence

Publisher: Society for Neuroscience

Date: 17-06-2015

DOI: 10.1523/JNEUROSCI.5043-14.2015

A systematic review of interventions for co-occurring substance use disorder and borderline personality disorder

Publisher: Elsevier BV

Date: 12-2011

DOI: 10.1016/J.JSAT.2011.05.004

Abstract: Rates of borderline personality disorder (BPD) among in iduals with substance use disorder (SUD) are estimated to be as high as 65%. Such elevated rates present considerable challenges for drug treatment services given that in iduals with co-occurring SUD and BPD have higher rates of relapse, treatment noncompliance, and poorer outcomes than those with either diagnosis alone. A systematic review investigating current treatment options for co-occurring SUD and BPD was conducted using Medline and PsycINFO. Randomized controlled trials were the focus. Six studies were included that examined the use of three psychosocial therapies: dialectical behavior therapy, dual focused schema therapy and dynamic deconstructive psychotherapy. Despite all studies demonstrating some treatment gains over time, there is currently insufficient evidence to recommend one treatment over another. Further research is needed to examine effective treatment options for co-occurring SUD and BPD, especially those that are likely to be applicable in mainstream drug treatment settings.

Acute harms associated with inhalant misuse: Co-morbidities and trends relative to age and gender among ambulance attendees

Publisher: Elsevier BV

Date: 09-2018

DOI: 10.1016/J.DRUGALCDEP.2018.05.026

Abstract: Inhalant misuse is the deliberate inhalation of products containing toluene to induce intoxication. Chronic harms associated with inhalant misuse are well described including alcohol and other drug use, mental health disorders, and suicidal behaviours. However, the nature of the acute harms from inhalants and characteristics of people who experience those harms are not well understood. Therefore, this study aimed to identify the acute harms associated with inhalant misuse attendances, and to determine whether these differ by age or gender. Ambulance attendance data (Victoria, Australia) from January 2012 to June 2017 were extracted from a database of coded ambulance records. 779 ambulance attendances involving inhalant misuse were identified. Attendance characteristics were categorised by age and gender. Co-morbidities of current mental health, self-harm and suicidal behaviour were assessed, plus the involvement of alcohol and other drugs. Overall, attendances related to the acute harms of inhalant misuse have decreased over time, although that trend has reversed from January 2015. Gender differentiated the acute harms associated with inhalant misuse. Males were older and presented with concurrent alcohol and other drug use. Females were younger and presented with concurrent suicidal ideation and self-injury. Attendances for under 15-year-olds are increasing this age group was over-represented, predominantly female, with a strong association with self-injury. Ambulance presentations related to inhalant misuse were associated with acute and serious harms. This study highlights that the acute treatment needs of those misusing inhalants are complex and may need to be tailored to gender and age groups.

Comparing rates and characteristics of emergency department presentations related to pharmaceutical opioid poisoning in Australia: a study protocol for a retrospective observational study

Publisher: BMJ

Date: 09-2020

DOI: 10.1136/BMJOPEN-2020-038979

Abstract: Pharmaceutical opioids are an important contributor to the global ‘opioid crisis’, and are implicated in 70% of Australia’s opioid-related mortality. However, there have been few studies which consider the relative contribution of different pharmaceutical opioids to harm. We aim to compare commonly used pharmaceutical opioids in terms of (1) rates of harm, and (2) demographic and clinical characteristics associated with that harm. Observational study of emergency department presentations for non-fatal poisoning related to pharmaceutical opioid use. Data from 2009 to 2019 will be extracted from the Victorian Emergency Minimum Dataset which contains data from public hospitals with dedicated emergency departments in Victoria, Australia’s second most populous state. A combination of free-text and International Classification of Diseases 10th Revision codes will be used to identify relevant cases, with manual screening of each case to confirm relevance. We will calculate supply-adjusted rates of presentations using Poisson regression for all pharmaceutical opioid cases identified, separately for nine commonly prescribed pharmaceutical opioids (buprenorphine, codeine, fentanyl, methadone, morphine, oxycodone, oxycodone-naloxone, tapentadol, tramadol), and for a multiple opioid category. We will use multinomial logistic regression to compare demographic and clinical characteristics, such as triage category, across opioid types. This work is conducted under approval 21427 from the Monash University Human Research Ethics Committee for ongoing injury surveillance. As per conditions of approval, cells of will not be reported, though zeroes will be preserved. We will present project findings in a peer-reviewed journal article as well as at relevant scientific conferences.

Ready2Change: Preliminary effectiveness of a telephone‐delivered intervention program for alcohol, methamphetamine and cannabis use problems

Publisher: Wiley

Date: 03-08-2021

DOI: 10.1111/DAR.13363

Abstract: Telehealth has considerable potential to overcome many of the barriers to accessing care for substance use problems, thereby increasing the opportunity for earlier intervention. The Ready2Change program is a multiple‐session outbound telephone‐delivered cognitive and behavioural intervention for mild‐to‐moderate substance use disorders, embedded within a long‐established 24/7 alcohol and drug helpline. We sought to analyse routinely collected program data in a preliminary study to examine the effectiveness of Ready2Change in reducing substance use problem severity and psychological distress. A retrospective analysis of program data from December 2013 to June 2018 was performed. Analysed cases were 249 clients living in Victoria, Australia with alcohol ( n = 191), meth hetamine ( n = 40) or cannabis ( n = 18) as their primary drug of concern. A within‐subjects design was used to examine pre‐ and post‐intervention substance use problem severity and psychological distress. For alcohol cases, there was a statistically significant decrease in alcohol problem severity [AUDIT, mean difference = −12.7, 95% confidence interval (CI) −14.0, −11.5]. Statistically significant reductions in drug problem severity (DUDIT) were observed for meth hetamine (mean difference = −17.3, 95% CI −20.9, −13.7) and cannabis (mean difference = −15.9, 95% CI −22.3, −9.6) cases. All groups showed reductions in problem severity for other substances used ( P 0.05) and psychological distress ( P 0.001). Results suggest Ready2Change benefits clients with alcohol, meth hetamine and cannabis use problems, with the potential to improve treatment access for health inequity groups including those living in remote areas. These findings warrant further investigation into the effectiveness of this program.

Effect of Cognitive Bias Modification on Early Relapse among Adults Undergoing Inpatient Alcohol Withdrawal Treatment: A Randomized Clinical Trial

Publisher: American Medical Association (AMA)

Date: 02-2021

DOI: 10.1001/JAMAPSYCHIATRY.2020.3446

High rates of alcohol consumption and related harm at schoolies week: a portal study.

Publisher: Elsevier BV

Date: 12-2014

DOI: 10.1111/1753-6405.12266

Abstract: To investigate alcohol consumption, substance use and risky and harmful behaviour among young people attending 'schoolies' week in Victoria. Breathalyser tests and brief surveys (n=558) measuring alcohol, energy drink and illicit drug use, and experience of aggressive incidents, alcohol-related injury and unprotected sex, were undertaken with young people attending schoolies week in Lorne and Torquay. Schoolies reported consuming a mean of 8.8 drinks in the current session, with a mean blood alcohol count (BAC) of 0.05 18.3% recorded a BAC of greater than 0.08. One in six participants had consumed alcohol with energy drinks 7.7% reported using illicit substances. Participants who co-consumed alcohol and energy drinks recorded a higher BAC than alcohol-only users. One in five participants had experienced alcohol-related harm at schoolies week, including aggressive incidents, alcohol-related injury and engagement in unprotected sex. Each alcoholic drink consumed increased the potential for involvement in aggressive incidents by 8% and alcohol-related accidents/injuries by 5% illicit drug use was associated with six times the likelihood of engaging in unprotected sex with a non-partner. Excessive alcohol consumption and experience of related harms are common among young people attending schoolies week. Harm reduction initiatives targeting schoolies week should focus on the consequences of excessive alcohol consumption, illicit drugs and the co-consumption of alcohol and energy drinks.

What are parents doing to reduce adolescent alcohol misuse? Evaluating concordance with parenting guidelines for adolescent alcohol use

Publisher: Springer Science and Business Media LLC

Date: 10-02-2015

DOI: 10.1186/S12889-015-1452-8

Going Online: The Affordances of Online Counseling for Families Affected by Alcohol and Other Drug Issues

Publisher: SAGE Publications

Date: 31-03-2019

DOI: 10.1177/1049732319838231

Abstract: Online counseling can overcome barriers families face when accessing support services for issues such as a relative’s alcohol or other drug use. However, little research has explored how online counseling platforms assist family members to improve their well-being and support their relative. We thematically analyzed 90 transcripts of online counseling sessions with family and friends of people who use alcohol, opioids, and hetamines in Australia between 2015 and 2016. In our analysis, we drew on the concept of affordances to articulate how online platforms afford or constrain potentially therapeutic encounters with families. We found online counseling enabled families to make first contact, relieve distress, plan appropriate action, improve communication, regain direction, and connect with local services. Sessions were constrained by Internet access, web-chat communication, counselors’ focus on referral, and limitations in addressing the wider concerns of families. The findings present opportunities for improving online services for families.

Parenting strategies for reducing adolescent alcohol use: a Delphi consensus study

Publisher: Springer Science and Business Media LLC

Date: 06-01-2011

DOI: 10.1186/1471-2458-11-13

Abstract: International concern regarding the increase in preventable harms attributed to adolescent alcohol consumption has led to growing political and medical consensus that adolescents should avoid drinking for as long as possible. For this recommendation to be adopted, parents and guardians of adolescents require information about strategies that they can employ to prevent or reduce their adolescent's alcohol use that are supported by evidence. The Delphi method was used to obtain expert consensus on parenting strategies effective in preventing and reducing adolescent alcohol consumption. A literature search identified 457 recommendations for parents to reduce their adolescent child's alcohol use. These recommendations were presented to a panel of 38 Australian experts who were asked to rate their importance over three survey rounds. There were 289 parenting strategies that were endorsed as important or essential in reducing adolescent alcohol use by ≥90% of the panel. These strategies were categorised into 11 sub-headings: things parents should know about adolescent alcohol use, delaying adolescent's introduction to alcohol, modelling responsible drinking and attitudes towards alcohol, talking to adolescents about alcohol, establishing family rules, monitoring adolescents when unsupervised, preparing adolescents for peer pressure, unsupervised adolescent drinking, what to do when an adolescent has been drinking without parental permission, hosting adolescent parties, and establishing and maintaining a good parent-child relationship. The endorsed strategies were written into a document suitable for parents. A comprehensive set of parenting strategies for preventing or reducing adolescent alcohol consumption were identified. These strategies can be promoted to parents to help them implement national recommendations for use of alcohol by young people.

Experiences of family members supporting a relative with substance use problems: a qualitative study

Publisher: Wiley

Date: 29-04-2019

DOI: 10.1111/SCS.12688

Abstract: Affected family members (AFMs) play an important role in supporting relatives with alcohol and/or other drug (AOD) misuse. However, they frequently lack support and experience considerable challenges to their own well-being. To explore the experience of AFMs who support a close relative with AOD misuse. Thirty-one AFMs were recruited through AOD helplines and through their social media accounts in the Australian state of Victoria. A semi-structured interview guide was used to inform data collection, focusing on their general experiences, impact of support-giving and support options. Interviews were audio-recorded and conducted by telephone. One overarching theme and six related subthemes were abstracted from the data. The overarching theme was conceptualised as Feeling overwhelmed by, and struggling with, the experience. Subthemes were as follows: Emotionally draining and exhausting, Maintaining constant vigilance: curbing social activities, Grappling with the financial impact, Struggling to cope with harmful family dynamics, Avoiding and containing aggression and Fearfulness and hopelessness about the future. Affected family members experienced wide-ranging harms, which affected their emotional, social and financial well-being, safety and family dynamics, and instilled a persistent sense of fearfulness and hopelessness about the future. The findings have implications for mental health nurses and other clinicians in AOD services to identify AFMs' needs and provide them with timely, accessible and appropriate support to help sustain their important role.

An audit examining the impact of a training session on interest in prescribing opioid maintenance treatment among psychiatrists and trainees

Publisher: SAGE Publications

Date: 02-2014

DOI: 10.1177/1039856213510751

Tracing the affordances of long-acting injectable depot buprenorphine: A qualitative study of patients’ experiences in Australia

Publisher: Elsevier BV

Date: 10-2071

DOI: 10.1016/J.DRUGALCDEP.2021.108959

Affective behavior and temperament predict the onset of smoking in adolescence.

Publisher: American Psychological Association (APA)

Date: 06-2015

DOI: 10.1037/ADB0000048

Abstract: Earlier use of tobacco in adolescence is associated with numerous adverse outcomes later in life. Although a number of studies have linked in idual differences in affective functioning to adolescent smoking, these have relied primarily on self-report measures, and the contribution of different dimensions of affect to the onset of tobacco use during this period remains unclear. The current study examined these issues in a s le of 180 adolescents recruited from an ongoing prospective, longitudinal study examining emotional development. At approximately age 12, participants completed a questionnaire measure of affective temperament and took part in a family interaction task that was coded observationally to provide measures of dysphoric, aggressive, and positive behaviors. At 2 subsequent assessments, which took place approximately 2.5 years and 4 years after the initial assessment, participants completed a questionnaire measure of substance use. In total, 70 participants initiated smoking between the ages of 12 and 17. An earlier onset of smoking was predicted by more aggressive and less positive observed behavior during the interaction task, as well as lower levels of self-reported temperamental Effortful Control. There were no associations between dysphoric behaviors, or temperamental measures of negative affectivity or surgency and the onset of smoking. The findings add to a small body of literature demonstrating that behavioral components of affect can prospectively predict substance use in adolescence and suggest that different dimensions of affect show unique relationships with early substance use. (PsycINFO Database Record

Help-seeking for substance use, anxiety and affective disorders among young people: Results from the 2007 Australian national survey of mental health and wellbeing

Publisher: SAGE Publications

Date: 08-2010

DOI: 10.3109/00048671003705458

Abstract: Objective: To provide a more detailed analysis of the relationship between type and severity of mental disorders (substance use, anxiety and affective disorders) and help-seeking in those aged 16–24 years compared to those aged 25–44 and 45–85 years. Method: Data from the National Survey of Mental Health and Wellbeing (NSMHWB) which was conducted in 2007. The survey s le comprised residents of private dwellings across Australia aged 16–85 years. Results: More than one in four Australians aged 16–24 years experienced a mental disorder in the preceding 12 months. This compared to one in five in those aged 16–85 years. Fewer than one in four 16–24-year-olds with a 12-month mental disorder accessed health services in a 12-month period compared with just over one in three of those aged 16–85. The gap in help-seeking was primarily related to higher rates of substance use disorders and low help-seeking associated with these, particularly in young men. Conclusions: Findings from the 2007 NSMHWB show that the gap in help-seeking in young people with mental health problems is largely due to high rates of substance use disorders and the low rates of help-seeking associated with these. In order to address this gap there is a need for better coordination and integration of mental health and alcohol and drug services within primary care settings. Population health approaches that tackle erroneous beliefs about alcohol and related harms and improve overall mental health literacy are also needed.

Interpreting neuropsychological impairment among adolescent inhalant users: Two case reports

Publisher: Cambridge University Press (CUP)

Date: 02-2008

DOI: 10.1111/J.1601-5215.2007.00236.X

Abstract: To illustrate the need to carefully consider mental health, psychosocial and motivational factors when investigating cognitive and intellectual impairment among chronic inhalant users. Two adolescent chronic inhalant users with similar psychosocial disadvantages (eg unstable and dysfunctional families, state-based care, school absenteeism and forensic issues) and histories of comorbid drug use and mental health problems were assessed using a battery of paper and pencil and computerised neuropsychological tests. Contrary to the expectations of her case manager, one participant performed within the normal range for her age in all domains of intellectual ability, while the other participant, in line with the expectations of her case manger, showed marked cognitive deficits and intellectual disability. The typically complex presentation of chronic inhalant users (ie disadvantaged psychosocial backgrounds, comorbid psychopathology and poor motivation/engagement) is rarely considered when investigating associated cognitive and intellectual functioning. Future research should more carefully consider the role of such factors, given the evidence suggesting that they can considerably alter (accentuate or diminish) the association between inhalant abuse and neuropsychological impairment.

Regional and rural clients’ presenting concerns and experiences of care when engaging with an online substance use counseling service

Publisher: Informa UK Limited

Date: 26-02-2022

DOI: 10.1080/16066359.2022.2039911

Can we enhance the clinical efficacy of cognitive and psychological approaches to treat substance use disorders through understanding their neurobiological mechanisms?

Publisher: Elsevier BV

Date: 11-2022

DOI: 10.1016/J.NEUBIOREV.2022.104899

Abstract: Despite decades of research in the field of addiction, relapse rates for substance use disorders remain high. Consequently, there has been growing focus on providing evidence-based treatments for substance use disorders, resulting in the increased development and use of cognitive and psychological interventions. Such treatment approaches, including contingency management, community-reinforcement approach, and cognitive bias modification, have shown promising clinical efficacy in reducing substance use and promoting abstinence during treatment. However, these interventions are still somewhat limited in achieving sustained periods of abstinence post-treatment. The neurobiological mechanisms underpinning these treatment approaches remain largely unknown and under-studied, in part, due to a lack of translational animal models. The adoption of a reverse translational approach may assist in development of more representative models that can facilitate elucidation of the mechanisms behind these clinically relevant interventions. This review examines our current understanding of addiction neurobiology from clinical, preclinical research and existing animal models, and considers how the efficacy of such behavioral-oriented interventions alone, or in combination with pharmacotherapy, may be enhanced to improve treatment outcomes.

Depression and suicidal behavior in adolescents: a multi-informant and multi-methods approach to diagnostic classification

Publisher: Frontiers Media SA

Date: 17-07-2014

DOI: 10.3389/FPSYG.2014.00766

Addiction, disinhibition, impulsivity, compulsivity: What's the difference, why does it matter and what is the role of context?

Publisher: Wiley

Date: 12-2004

DOI: 10.1111/J.1360-0443.2004.00913.X

Protocol for a cluster randomised crossover pilot trial of Goal Management Training⁺ (GMT⁺) for methamphetamine use disorder

Publisher: Elsevier BV

Date: 10-2022

DOI: 10.1016/J.CONCTC.2022.100969

Effectiveness of a Stand-alone Telephone-Delivered Intervention for Reducing Problem Alcohol Use: A Randomized Clinical Trial

Publisher: American Medical Association (AMA)

Date: 11-2022

DOI: 10.1001/JAMAPSYCHIATRY.2022.2779

Abstract: Despite the magnitude of alcohol use problems globally, treatment uptake remains low. Telephone-delivered interventions have potential to overcome many structural and in idual barriers to help seeking, yet their effectiveness as a stand-alone treatment for problem alcohol use has not been established. To examine the effectiveness of the Ready2Change telephone-delivered intervention in reducing alcohol problem severity up to 3 months among a general population s le. This double-blind, randomized clinical trial recruited participants with an Alcohol Use Disorders Identification Test (AUDIT) score of greater than 6 (for female participants) and 7 (for male participants) from across Australia during the period of May 25, 2018, to October 2, 2019. Telephone assessments occurred at baseline and 3 months after baseline (84.9% retention). Data collection was finalized September 2020. The telephone-based cognitive and behavioral intervention comprised 4 to 6 telephone sessions with a psychologist. The active control condition comprised four 5-minute telephone check-ins from a researcher and alcohol and stress management p hlets. The primary outcome was change in alcohol problem severity, measured with the AUDIT total score. Drinking patterns were measured with the Timeline Followback (TLFB) instrument. This study included a total of 344 participants (mean [SD] age, 39.9 [11.4] years range, 18-73 years 177 male participants [51.5%]) 173 participants (50.3%) composed the intervention group, and 171 participants (49.7%) composed the active control group. Less than one-third of participants (101 [29.4%]) had previously sought alcohol treatment, despite a high mean (SD) baseline AUDIT score of 21.5 (6.3) and 218 (63.4%) scoring in the probable dependence range. For the primary intention-to-treat analyses, there was a significant decrease in AUDIT total score from baseline to 3 months in both groups (intervention group decrease, 8.22 95% CI, 7.11-9.32 P & .001 control group decrease, 7.13 95% CI, 6.10-8.17 P & .001), but change over time was not different between groups (difference, 1.08 95% CI, −0.43 to 2.59 P = .16). In secondary analyses, the intervention group showed a significantly greater reduction in the AUDIT hazardous use domain relative to the control group at 3 months (difference, 0.58 95% CI, 0.02-1.14 P = .04). A greater reduction in AUDIT total score was observed for the intervention group relative to the control group when adjusting for exposure to 2 or more sessions (difference, 3.40 95% CI, 0.36-6.44 P = .03) but not 1 or more sessions (per-protocol analysis). Based on the primary outcome, AUDIT total score, this randomized clinical trial did not find superior effectiveness of this telephone-based cognitive and behavioral intervention compared with active control. However, the intervention was effective in reducing hazardous alcohol use and reduced alcohol problem severity when 2 or more sessions were delivered. Trial outcomes demonstrate the potential benefits of this highly scalable and accessible model of alcohol treatment. ANZCTR Identifier: ACTRN12618000828224

Reasons for using web-based counselling among family and friends impacted by problem gambling

Publisher: Springer Science and Business Media LLC

Date: 29-07-2013

DOI: 10.1186/2195-3007-3-12

Cohort profile: Using primary care data to understand Opioid Prescribing, Policy Impacts and Clinical Outcomes (OPPICO) in Victoria, Australia.

Publisher: BMJ

Date: 05-2023

DOI: 10.1136/BMJOPEN-2022-067746

Abstract: The OPPICO cohort is a population-based cohort based on non-identifiable electronic health records routinely collected from 464 general practices in Victoria, Australia, created with the aim of understanding opioid prescribing, policy impacts and clinical outcomes. The aim of this paper is to provide a profile of the study cohort by summarising available demographic, clinical and prescribing characteristics. The cohort described in this paper comprises people who were aged at least 14 years at cohort entry, and who were prescribed an opioid analgesic at least once at participating practices for a total of 1 137 728 person-years from 1 January 2015 to 31 December 2020. The cohort was formed using the data collected from electronic health records through the Population Level Analysis and Reporting (POLAR) system. The POLAR data primarily consist of patient demographics, clinical measurements, Australian Medicare Benefits Scheme item numbers, diagnoses, pathology testing and prescribed medications. In total, the cohort consists of 676 970 participants with 4 389 185 opioid prescription records from 1 January 2015 to 31 December 2020. Approximately half (48.7%) received a single opioid prescription, and 0.9% received more than 100 opioid prescriptions. The mean number of opioid prescriptions per patient was 6.5 (SD=20.9) prescriptions for strong opioids accounted for 55.6% of all opioid prescriptions. The OPPICO cohort data will be used for various types of pharmacoepidemiological research, including examining the impact of policy changes on coprescription of opioids with benzodiazepines and gabapentin, and monitoring trends and patterns of other medication utilisation. Through data-linkage between our OPPICO cohort and hospital outcome data, we will examine whether policy changes for opioid prescribing lead to changes in prescription opioid-related harms, and other drug and mental health-related outcomes. EU PAS Register (EUPAS43218, prospectively registered).

Trends in cannabis-related ambulance presentations from 2000 to 2013 in Melbourne, Australia

Publisher: Elsevier BV

Date: 10-2015

DOI: 10.1016/J.DRUGALCDEP.2015.08.021

Abstract: The current burden of cannabis-related presentations to emergency health services is largely unknown. This paper presents data collected over a 13-year period in metropolitan Melbourne, Australia as part of the Ambo Project, a unique surveillance system that analyses and codes paramedic records for drug-related trends and harms. Cannabis-related ambulance attendances involving 15-59 year olds in metropolitan Melbourne were analysed retrospectively from 2000 to 2013 (n=10,531). Trends and attendance characteristics were compared among cannabis only (CO)-, cannabis and alcohol (CA)- and cannabis with polydrug use (CP)-related attendances. Changes in alcohol and drug involvements in cannabis-related attendances were explored. Rates of cannabis-related ambulance attendances increased significantly over the study period. Increasing rate of attendances per 100,000 population per year changed from 0.6 (2000-2010) to 5.5 (2010-2013). This sharp change was driven by CO- and CP-related attendances (rate of CA-related attendance increased steadily). The highest increasing rate (15.6) was for CO-related attendances among 15-29 years old males (2010-2013). Crystal meth hetamine became the most common illicit co-intoxicant amongst cannabis presentations in 2013. Relative to the total drug-related burden on ambulance services, cannabis-related presentations appear to be a small but significant and increasing problem. Significant changes in trends across other drug involvement and demographic subgroups suggest a possible shift in the cannabis using population and/or a change in using behaviours. Public health strategies should raise awareness of the increased risk posed by cannabis polydrug use and high attendance subpopulations should be determined.

Cortical inhibition within motor and frontal regions in alcohol dependence post-detoxification: A pilot TMS-EEG study

Publisher: Informa UK Limited

Date: 04-08-2016

DOI: 10.3109/15622975.2015.1066512

Abstract: Preclinical studies suggest that cortical alterations within the prefrontal cortex (PFC) are critical to the pathophysiology of alcohol dependence. Combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) allows direct assessment of cortical excitability and inhibition within the PFC of human subjects. We report the first application of TMS-EEG to measure these indices within the PFC of alcohol-dependent (ALD) patients post-detoxification. Cortical inhibition was assessed in 12 ALD patients and 14 healthy controls through single and paired-pulse TMS paradigms. Long-interval cortical inhibition indexed cortical inhibition in the PFC. In the motor cortex (MC), short- interval intracortical inhibition and cortical silent period determined inhibition, while intracortical facilitation measured facilitation, resting and active motor threshold indexed cortical excitability. ALD patients demonstrated altered cortical inhibition across the bilateral frontal cortices relative to controls. There was evidence of altered cortical excitability in ALD patients however, no significant differences in MC inhibition. Our study provides first direct evidence of reduced cortical inhibition in the PFC of ALD patients post-detoxification. Altered cortical excitability in the MC may reflect hyper-excitability within the cortex associated with chronic alcohol consumption. These findings provide initial neurophysiological evidence of disrupted cortical excitability within the PFC of ALD patients.

Improved Outcomes Following a Single Session Web-Based Intervention for Problem Gambling

Publisher: Springer Science and Business Media LLC

Date: 25-08-2016

DOI: 10.1007/S10899-016-9638-2

Abstract: Research suggests online interventions can have instant impact, however this is yet to be tested with help-seeking adults and in particular those with problem gambling. This study seeks to determine the immediate impact of a single session web-based intervention for problem gambling, and to examine whether sessions evaluated positively by clients are associated with greater improvement. The current study involved 229 participants classified as problem gamblers who agreed to participate after accessing Gambling Help Online between November 2010 and February 2012. Almost half were aged under 35 years of age (45 %), male (57 %) as well as first time treatment seekers (62 %). Participants completed measures of readiness to change and distress both prior to and post-counselling. Following the provision of a single-session of counselling, participants completed ratings of the character of the session (i.e., degree of depth and smoothness) post-counselling. A significant increase in confidence to resist and urge to gamble and a significant decrease in distress (moderate effect size d = .56 and .63 respectively) was observed after receiving online counselling. A hierarchical regression indicated the character of the session was a significant predictor of change in confidence, however only the sub-scale smoothness was a significant predictor of change in distress. This was the case even after controlling for pre-session distress, session word count and client characteristics (gender, age, preferred gambling activity, preferred mode of gambling, gambling severity, and preferred mode of help-seeking). These findings suggest that single session web-based counselling for problem gambling can have immediate benefits, although further research is required to examine the impact on longer-term outcomes.

Substance use outcomes following treatment

Publisher: SAGE Publications

Date: 11-07-2017

DOI: 10.1177/0004867415625815

Abstract: Our understanding of patient pathways through specialist Alcohol and Other Drug treatment and broader health/welfare systems in Australia remains limited. This study examines how treatment outcomes are influenced by continuity in specialist Alcohol and Other Drug treatment, engagement with community services and mutual aid, and explores differences between clients who present with a primary alcohol problem relative to those presenting with a primary drug issue. In a prospective, multi-site treatment outcome study, 796 clients from 21 Alcohol and Other Drug services in Victoria and Western Australia completed a baseline interview between January 2012 and January 2013. A total of 555 (70%) completed a follow-up assessment of subsequent service use and Alcohol and Other Drug use outcomes 12-months later. Just over half of the participants (52.0%) showed reliable reductions in use of, or abstinence from, their primary drug of concern. This was highest among clients with meth/ hetamine (66%) as their primary drug of concern and lowest among clients with alcohol as their primary drug of concern (47%), with 31% achieving abstinence from all drugs of concern. Continuity of specialist Alcohol and Other Drug care was associated with higher rates of abstinence than fragmented Alcohol and Other Drug care. Different predictors of treatment success emerged for clients with a primary drug problem as compared to those with a primary alcohol problem mutual aid attendance (odds ratio = 2.5) and community service engagement (odds ratio = 2.0) for clients with alcohol as the primary drug of concern, and completion of the index treatment (odds ratio = 2.8) and continuity in Alcohol and Other Drug care (odds ratio = 1.8) when drugs were the primary drugs of concern. This is the first multi-site Australian study to include treatment outcomes for alcohol and cannabis users, who represent 70% of treatment seekers in Alcohol and Other Drug services. Results suggest a substantial proportion of clients respond positively to treatment, but that clients with alcohol as their primary drug problem may require different treatment pathways, compared to those with illicit drug issues, to maximise outcomes.

A Model for Predicting Clinician Satisfaction with Clinical Supervision

Publisher: Informa UK Limited

Date: 02-01-2014

DOI: 10.1080/07347324.2014.856227

Predictors of cognitive functioning in presentations to a community-based specialist addiction neuropsychology service

Publisher: Cambridge University Press (CUP)

Date: 14-02-2023

DOI: 10.1017/BRIMP.2021.38

Abstract: Cognitive impairment is common in in iduals presenting to alcohol and other drug (AOD) settings and the presence of biopsychosocial complexity and health inequities can complicate the experience of symptoms and access to treatment services. A challenge for neuropsychologists in these settings is to evaluate the likely in idual contribution of these factors to cognition when providing an opinion regarding diagnoses such as acquired brain injury (ABI). This study therefore aimed to identify predictors of cognitive functioning in AOD clients attending for neuropsychological assessment. Clinical data from 200 clients with AOD histories who attended for assessment between 2014 and 2018 were analysed and a series of multiple regressions were conducted to explore predictors of cognitive impairment including demographic, diagnostic, substance use, medication, and mental health variables. Regression modelling identified age, gender, years of education, age of first use, days of abstinence, sedative load, emotional distress and diagnoses of ABI and developmental disorders as contributing to aspects of neuropsychological functioning. Significant models were obtained for verbal intellectual functioning (Adj R 2 = 0.19), nonverbal intellectual functioning (Adj R 2 = 0.10), information processing speed (Adj R 2 = 0.20), working memory (Adj R 2 = 0.05), verbal recall (Adj R 2 = 0.08), visual recall (Adj R 2 = 0.22), ided attention (Adj R 2 = 0.14), and cognitive inhibition (Adj R 2 = 0.07). These findings highlight the importance of careful provision of diagnoses in clients with AOD histories who have high levels of unmet clinical needs. They demonstrate the interaction of premorbid and potentially modifiable comorbid factors such as emotional distress and prescription medication on cognition. Ensuring that modifiable risk factors for cognitive impairment are managed may reduce experiences of cognitive impairment and improve diagnostic clarity.

Transitioning to civilian life: The importance of social group engagement and identity among Australian Defence Force veterans

Publisher: SAGE Publications

Date: 20-09-2021

DOI: 10.1177/00048674211046894

Abstract: Veterans transitioning to civilian life after leaving the military face unique health concerns. Although there is a significant body of research exploring veterans’ experiences of transition and predictors of well-being, there are limited studies examining how social group engagement influences veterans’ transition. We explored how Australian Defence Force veterans’ social group engagement and identity influenced their adjustment to civilian life and well-being. Forty Australian veterans (85% male mean age = 37 years, range = 25–57 years) took part in in-depth, semi-structured interviews. Participants completed two mapping tasks (a social network map and life course map) that provided a visual component to the interviews. Interview transcripts were analysed thematically and interpreted by adopting a social identity approach. Joining the military involved a process of socialisation into military culture that for most participants led to the development of a military identity. An abrupt or difficult discharge from defence was often associated with a negative impact on social group engagement and well-being in civilian life. Veterans’ social group memberships may act not only as positive psychological resources during transition but also as a potential source of conflict, especially when trying to re-engage with civilian groups with different norms or beliefs. Military values inscribed within a veteran’s sense of self, including a strong sense of service, altruism and giving back to their community, may operate as positive resources and promote social group engagement. Engaging with supportive social groups can support transition to civilian life. Reintegration may be improved via effective linkage with programmes (e.g. volunteering, ex-service support organisations) that offer supportive social networks and draw upon veterans’ desire to give back to community. Social mapping tasks that visualise veterans’ social group structures may be useful for clinicians to explore the roles and conflicts associated with veterans’ social group memberships during transition.

Cannabis and adolescent brain development

Publisher: Elsevier BV

Date: 04-2015

DOI: 10.1016/J.PHARMTHERA.2014.11.009

Abstract: Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.

Amygdala volume mediates the relationship between externalizing symptoms and daily smoking in adolescence: A prospective study

Publisher: Elsevier BV

Date: 06-2018

DOI: 10.1016/J.PSCYCHRESNS.2018.03.007

Abstract: The current study examined amygdala and orbitofrontal cortex (OFC) volumes as mediators of the relationship between externalizing symptoms and daily smoking in adolescence. Externalizing behaviors are among the most robust predictors of adolescent smoking, and there is emerging evidence that volume reductions in the amygdala and OFC are associated with risk for substance misuse as well as aggressive, impulsive, and disinhibited tendencies. Using a prospective longitudinal design, we recruited 109 adolescents who provided data on brain volume and externalizing behaviors at age 12, and on smoking at age 18. Daily smoking at age 18 (n = 27) was predicted by externalizing behaviors (measured by the self-report Child Behavior Checklist, CBCL) as well as smaller right amygdala volumes. Right amygdala volumes mediated the relationship between externalizing symptoms and later smoking. These findings provide important insight into the neurobiological risk factors associated with adolescent smoking, and, more generally, into factors that may be associated with vulnerability to substance use disorders and related psychopathology.

The neurobiological basis of temperament: Towards a better understanding of psychopathology

Publisher: Elsevier BV

Date: 2006

DOI: 10.1016/J.NEUBIOREV.2005.09.003

Abstract: The ability to characterise psychopathologies on the basis of their underlying neurobiology is critical in improving our understanding of disorder etiology and making more effective diagnostic and treatment decisions. Given the well-documented relationship between temperament (i.e. core personality traits) and psychopathology, research investigating the neurobiological substrates that underlie temperament is potentially key to our understanding of the biological basis of mental disorder. We present evidence that specific areas of the prefrontal cortex (including the dorsolateral prefrontal, anterior cingulate, and orbitofrontal cortices) and limbic structures (including the amygdala, hippoc us and nucleus accumbens) are key regions associated with three fundamental dimensions of temperament: Negative Affect, Positive Affect, and Constraint. Proposed relationships are based on two types of research: (a) research into the neurobiological correlates of affective and cognitive processes underlying these dimensions and (b) research into the neurobiology of various psychopathologies, which have been correlated with these dimensions. A model is proposed detailing how these structures might comprise neural networks whose functioning underlies the three temperaments. Recommendations are made for future research into the neurobiology of temperament, including the need to focus on neural networks rather than in idual structures, and the importance of prospective, longitudinal, multi-modal imaging studies in at-risk youth.

Trends in quetiapine use and non‐fatal quetiapine‐related ambulance attendances

Publisher: Wiley

Date: 27-01-2013

DOI: 10.1111/DAR.12028

Abstract: Concern about the non-medical use of quetiapine and related acute harms is growing. Case series cite quetiapine as a potential drug of misuse, while recent research questions its relative safety in comparison with other atypical antipsychotic preparations. This paper explores population-level patterns of quetiapine-related ambulance attendances over time, identifying associated risk factors and potential subpopulations at-risk of acute harms. A retrospective analysis of quetiapine-, olanzapine- and risperidone-related ambulance attendances in metropolitan Melbourne and prescription data in Victoria, Australia. Trends in ambulance attendance and prescription rates, attendance characteristics, and associated risk factors were explored from 2001 to 2010. Quetiapine was consistently associated with substantially higher rates of ambulance attendances relative to prescription availability than olanzapine or risperidone. Quetiapine prescribing rates increased at a significantly greater magnitude than olanzapine or risperidone, leading to substantial increases in quetiapine attendances by population. Quetiapine-related attendances were associated with concurrent heroin and opioid replacement therapy toxicity, history of heroin and alcohol misuse, mood disorders, low Glasgow Coma Scale and women. Trends in quetiapine-related ambulance attendances indicate rising community-level harms and greater harm relative to other atypical antipsychotics, while prescription patterns suggest increasing quetiapine availability. The association of quetiapine-related attendances with concurrent heroin and opioid replacement therapy toxicity as well as previous heroin and alcohol misuse suggest illicit and poly-drug users are a subpopulation at greater risk of quetiapine-related harms, consistent with emerging evidence of the use, misuse and ersion of quetiapine.

Dose-related psychotic symptoms in chronic methamphetamine users: Evidence from a prospective longitudinal study

Publisher: American Medical Association (AMA)

Date: 03-2013

DOI: 10.1001/JAMAPSYCHIATRY.2013.283

Abstract: Meth hetamine is associated with psychotic phenomena, but it is not clear to what extent this relationship is due to premorbid psychosis among people who use the drug. To determine the change in the probability of psychotic symptoms occurring during periods of meth hetamine use. Longitudinal prospective cohort study. A fixed-effects analysis of longitudinal panel data, consisting of 4 noncontiguous 1-month observation periods, was used to examine the relationship between changes in meth hetamine use and the risk of experiencing psychotic symptoms within in iduals over time. Sydney and Brisbane, Australia. A total of 278 participants 16 years of age or older who met DSM-IV criteria for meth hetamine dependence on entry to the study but who did not meet DSM-IV criteria for lifetime schizophrenia or mania. Clinically significant psychotic symptoms in the past month, defined as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations, or unusual thought content. The number of days of meth hetamine use in the past month was assessed using the Opiate Treatment Index. There was a 5-fold increase in the likelihood of psychotic symptoms during periods of meth hetamine use relative to periods of no use (odds ratio [OR], 5.3 [95% CI, 3.4-8.3] P < .001), this increase being strongly dose-dependent (1-15 days of meth hetamine use vs abstinence in the past month: OR, 4.0 [95% CI, 2.5-6.5] ≥16 days of meth hetamine use vs abstinence in the past month: OR, 11.2 [95% CI, 5.9-21.1]). Frequent cannabis and/or alcohol use (≥16 days of use in the past month) further increased the odds of psychotic symptoms (cannabis: OR, 2.0 [95% CI, 1.1-3.5] alcohol: OR, 2.1 [95% CI, 1.1-4.2]). There was a large dose-dependent increase in the occurrence of psychotic symptoms during periods of meth hetamine use among users of the drug.

‘Extreme personal stress’ and ‘a lot of pain’: Exploring the physical, mental and social contexts of extramedical pharmaceutical opioid use in Australian paramedic case descriptions

Publisher: Wiley

Date: 07-07-2020

DOI: 10.1111/DAR.13118

A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial

Publisher: Wiley

Date: 29-05-2023

DOI: 10.5694/MJA2.51991

Abstract: To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening. Single‐site, double‐blinded randomised controlled trial. Maroondah BreastScreen (Eastern Health, Melbourne), part of the national breast cancer screening program. Women aged 40 years or more, with or without a history of breast cancer and reporting any alcohol consumption, who attended the clinic for routine mammography during 5 February – 27 August 2021. Active arm: animation including brief alcohol intervention (four minutes) and lifestyle health promotion (three minutes). Control arm: lifestyle health promotion only. Change in proportion of women who identified alcohol use as a clear risk factor for breast cancer (scaled response measure). The mean age of the 557 participants was 60.3 years (standard deviation, 7.7 years range, 40–87 years) 455 had recently consumed alcohol (82%). The proportions of participants aware that alcohol use increased the risk of breast cancer were larger at four weeks than at baseline for both the active intervention (65% v 20% odds ratio [OR], 41 95% confidence interval [CI], 18–97) and control arms of the study (38% v 20% OR, 4.9 95% CI, 2.8–8.8), but the change over time was greater for the active intervention arm (arm × time: P 0.001). Alcohol literacy also increased to a greater extent in the active than the control arm, but alcohol consumption did not significantly change in either arm. A tailored brief alcohol intervention for women attending breast screening was effective for improving awareness of the increased breast cancer risk associated with alcohol use and alcohol literacy more broadly. Such interventions are particularly important given the rising prevalence of risky drinking among middle‐aged and older women and evidence that even very light alcohol consumption increases breast cancer risk. ClinicalTrials.gov , NCT04715516 (prospective 20 January 2021).

Orbitofrontal volumes in early adolescence predict initiation of cannabis use: A 4-year longitudinal and prospective study

Publisher: Elsevier BV

Date: 04-2012

DOI: 10.1016/J.BIOPSYCH.2011.10.029

Abstract: There is growing evidence that long-term, heavy cannabis use is associated with alterations in regional brain volumes. Although these changes are frequently attributed to the neurotoxic effects of cannabis, it is possible that some abnormalities might predate use and represent markers of vulnerability. To date, no studies have examined whether structural brain abnormalities are present before the onset of cannabis use. This study aims to determine whether adolescents who have initiated cannabis use early (i.e., before age 17 years) show premorbid structural abnormalities in the amygdala, hippoc us, orbitofrontal cortex, and anterior cingulate cortex. Participants (n = 121) were recruited from primary schools in Melbourne, Australia, as part of a larger study examining adolescent emotional development. Participants underwent structural magnetic resonance imaging at age 12 years and were assessed for cannabis use 4 years later, at age 16 years. At the follow-up assessment, 28 participants had commenced using cannabis (16 female subjects [57%]), and 93 had not (43 female subjects [46%]). Smaller orbitofrontal cortex volumes at age 12 years predicted initiation of cannabis use by age 16 years. The volumes of other regions (amygdala, hippoc us, and anterior cingulate cortex) did not predict later cannabis use. These findings suggest that structural abnormalities in the orbitofrontal cortex might contribute to risk for cannabis exposure. Although the results have important implications for understanding neurobiological predictors of cannabis use, further research is needed to understand their relationship with heavier patterns of use in adulthood as well as later abuse of other substances.

A comparative study of blood alcohol concentrations in Australian night-time entertainment districts

Publisher: Wiley

Date: 07-2014

DOI: 10.1111/DAR.12145

Abstract: There is little research describing how intoxication levels change throughout the night in entertainment districts. This research aims to describe levels of alcohol intoxication across multiple Australian metropolitan and regional nightlife districts. This study was conducted in the night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia. Data collection occurred approximately fortnightly in each city on a Friday or Saturday night between 8 pm and 5 am. Brief structured interviews (3-10 min) and breathalyser tests were undertaken in busy thoroughfares over six months. Of the 7037 in iduals approached to participate in the study, 6998 [61.8% male, mean age 24.89 years (standard deviation 6.37 range 18-73)] agreed to be interviewed. There was a linear increase in blood alcohol concentration (BAC) levels throughout the night. Post hoc testing revealed significantly more highly intoxicated participants (i.e. BAC above 0.10 mg of alcohol per 100 mL of blood) after midnight (P < 0.05). The overall mean BAC was 0.06 mg/100 mL. Men were more intoxicated than women earlier in the night, but gender differences disappeared by 3 am. There was no age differences in intoxication earlier in the night, but after midnight, patrons over the age of 21 showed increasing BAC levels. There is a consistent trend across the cities of high to very high levels of intoxication later in the night, with trends after midnight being significantly different to those before.

Probes of behaviour regulation: Olfactory models in addiction

Publisher: Cambridge University Press

Date: 19-10-2006

DOI: 10.1017/CBO9780511543623.009

Affected Others Responsivity to Gambling Harm: An International Taxonomy of Consumer-Derived Behaviour Change Techniques

Publisher: MDPI AG

Date: 04-02-2021

DOI: 10.3390/JCM10040583

Abstract: Affected others impacted by someone else’s gambling utilise numerous behaviour change strategies to minimise gambling-related harm but knowledge on what these strategies are and how they are implemented is limited. This study aimed to develop a comprehensive data-driven taxonomy of the types of self-help strategies used by affected others, and to categorize these into high-level behaviour change techniques (BCTs). Two taxonomies were developed using an inductive and deductive approach which was applied to a dataset of online sources and organised into the Rubicon model of action phases. These taxonomies were family-focused (how to reduce the impact of gambling harm on families) and gambler-focused (how to support the gambler in behaviour change). In total, 329 online sources containing 3536 different strategies were identified. The family-focused classification contained 16 BCTs, and the most frequent were professional support, financial management and planned consequences. The gambler-focused classification contained 11 BCTs, and the most frequent were feedback on behaviours, professional support and financial management. The majority of family- and gambler-focused BCTs fell under the actional phase of the Rubicon model. Grounded in lived experience, the findings highlight the need for intervention and resource development that includes a wide range of specific techniques that affected others can utilise.

Making multiple ‘online counsellings’ through policy and practice: an evidence-making intervention approach

Publisher: Elsevier BV

Date: 03-2018

DOI: 10.1016/J.DRUGPO.2017.12.008

Abstract: Online counselling services for a range of health conditions have proliferated in recent years. However, there is ambiguity and tension around their role and function. It is often unclear whether online counselling services are intended to provide only a brief intervention, the provision of information or referral, or constitute an alternative to face-to-face treatment. In line with recent analyses of alcohol and other drug (AOD) policy and interventions that draw on a critical social science perspective, we take an evidence-making intervention approach to examine how online counselling in the AOD field is made in policy and through processes of local implementation. In this article, we analyse how online AOD counselling interventions and knowledges are enacted in Australia's AOD policy, and compare these enactments with an analysis of information about Australia's national online AOD counselling service, Counselling Online, and transcripts of counselling sessions with clients of Counselling Online. We suggest that while the policy enacts online counselling as a brief intervention targeting AOD use, and as an avenue to facilitate referral to face-to-face treatment services, in its implementation in practice online counselling is enacted in more varied ways. These include online counselling as attempting to attend to AOD use and interconnected psychosocial concerns, as a potential form of treatment in its own right, and as supplementing face-to-face AOD treatment services. Rather than viewing online counselling as a singular and stable intervention object, we suggest that multiple 'online counsellings' emerge in practice through local implementation practices and knowledges. We argue that the frictions that arise between policy and practice enactments need to be considered by policy makers, funders, clinicians and researchers as they affect how the concerns of those targeted by the intervention are attended to.

A model for lesbian, bisexual and queer-related influences on alcohol consumption and implications for policy and practice

Publisher: Informa UK Limited

Date: 14-10-2016

DOI: 10.1080/13691058.2015.1089602

Abstract: Research consistently reports higher rates of problematic drinking among lesbian, bisexual and queer women than among heterosexual women, but relatively little research has identified underlying factors. Within this context, the aim of the present study was to qualitatively explore the sociocultural influences on alcohol consumption among lesbian, bisexual and queer women in Australia. An ethnographic study including in-depth interviews and 10 sessions of participant observation was conducted with 25 Australian lesbian, bisexual and queer women. Analysis of transcripts and fieldnotes focused on lesbian, bisexual and queer-related influences on alcohol consumption. Three lesbian, bisexual and queer-related factors were identified that influenced alcohol use: (1) coping, (2) connection and (3) intersections with lesbian, bisexual and queer identity. Most participants reported consuming alcohol to cope with discrimination or to connect with like-minded others. Alcohol use had positive influences for some women through facilitating social connection and wellbeing. Women with a high lesbian, bisexual and queer identity salience were more likely to seek lesbian, bisexual and queer community connection involving alcohol, to publicly identify as lesbian, bisexual and queer and to experience discrimination. National policies need to address underlying causes of discrimination against lesbian, bisexual and queer women. Alcohol policies and clinical interventions should acknowledge the impact of discrimination on higher alcohol consumption amongst lesbian, bisexual and queer women compared with heterosexual women, and should utilise health promotion messages regarding safe drinking that facilitate lesbian, bisexual and queer social connection.

Treating comorbid substance use disorders in schizophrenia

Publisher: Informa UK Limited

Date: 2010

DOI: 10.3109/09540261003689958

Abstract: To review the literature on pharmacological and psychosocial treatment approaches for people with schizophrenia and comorbid substance use disorder(s) (SUD). Selective literature review. Despite the high prevalence of comorbid SUD among people with schizophrenia, there is a considerable paucity of rigorously conducted randomized controlled treatment trials. While there is some evidence for clozapine, and for the adjunctive use of agents such as naltrexone for comorbid alcohol dependence, the available literature largely comprises case studies, case series, open label studies and retrospective surveys. In terms of psychosocial approaches, there is reasonable consensus that integrated approaches are most appropriate. Regarding specific aspects of care, motivational interviewing, cognitive behavioural therapy and contingency management have an emerging supportive literature, as do family interventions. However, there is no 'one size fits all', and a flexible approach with the ability to apply specific components of care to particular in iduals, is required. Group-based therapies and longer-term residential services have an important role for some patients, but further research is required to delineate more clearly which patients will benefit from these strategies. While there is growing (albeit limited) evidence that integrated and well articulated interventions that encompass pharmacological and psychosocial parameters can be beneficial for people with schizophrenia and comorbid SUD, there remains a considerable gap in the literature available to inform evidence-based practice.

Alcohol and Drug Misuse in the Elderly

Publisher: SAGE Publications

Date: 04-2011

DOI: 10.3109/00048674.2010.549997

New College policy and advocacy work contributes to addressing methamphetamine-related harms in Australia and New Zealand

Publisher: SAGE Publications

Date: 12-2015

DOI: 10.1177/1039856215616882F

A systematic review of risk factors for methamphetamine-associated psychosis

Publisher: SAGE Publications

Date: 16-01-2018

DOI: 10.1177/0004867417748750

Abstract: Chronic meth hetamine use is commonly associated with the development of psychotic symptoms. The predictors and correlates of meth hetamine-associated psychosis are poorly understood. We sought to systematically review factors associated with psychotic symptoms in adults using illicit hetamine or meth hetamine. A systematic literature search was performed on MEDLINE (OVID), PsycINFO and EMBASE databases from inception to 8 December 2016. The search strategy combined three concept areas: meth hetamine or hetamine, psychosis and risk factors. Included studies needed to compare adults using illicit meth hetamine or hetamine, using a validated measure of psychosis, on a range of risk factors. Of 402 identified articles, we removed 45 duplicates, 320 articles based on abstract/title and 17 ineligible full-text articles, leaving 20 included studies that were conducted in 13 populations. Two co-authors independently extracted the following data from each study: country, setting and design participant demographic and clinical details s le size measure/s used and measures of association between psychosis outcomes and risk factors. In idual study quality was assessed using a modified Newcastle-Ottawa Scale, and strength of evidence was assessed using GRADE criteria. Frequency of meth hetamine use and severity of meth hetamine dependence were consistently found to be associated with psychosis, and sociodemographic factors were not. There was inconsistent evidence available for all other risk factors. In idual study quality was low–moderate for the majority of studies. Heterogeneity in study outcomes precluded quantitative synthesis of outcomes across studies. The most consistent correlates of psychotic symptoms were increased frequency of meth hetamine use and dependence on meth hetamine. The findings of this review highlight the need for targeted assessment and treatment of meth hetamine use in in iduals presenting with psychosis.

Harms associated with extramedical use of prescription opioid analgesics in Australia: A scoping review

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.SAPHARM.2018.07.001

Abstract: Evidence is accumulating globally on harms from extramedical prescription opioid analgesic (POA) use. The aim of this scoping review was to explore harms and documented risk factors associated with extramedical POA use in Australia. MEDLINE, EMBASE, PsycINFO and CINAHL were searched for original studies published between January 2000 and February 2018. Studies were eligible for inclusion if: 1) POA use was explicitly reported, 2) extramedical use was evident 3) harm was explicitly reported, 4) data were collected in/after 2000, 5) conducted in adults and 6) undertaken in Australia. We identified 560 articles and 16 met the inclusion criteria. Harms reported from extramedical POA use included: increased health service utilization (n = 5), non-fatal overdose (n = 6), fatal overdose (n = 5), injection-related injuries or diseases (n = 4), engagement in crime (n = 2), loss of employment (n = 1), and foreign body pulmonary embolization (n = 1). Multiple drug toxicity was reported as the cause of death in up to 83% of fatal overdose cases. Risk factors for harm included being male, aged 31-49 years, a history of chronic non-cancer pain, mental health disorders and/or substance abuse, and concomitant use of benzodiazepines, antidepressants or other centrally-acting substances. Extramedical use of POAs is associated with a range of harms, including fatal and non-fatal overdose. Polysubstance use with other centrally-acting substances was often implicated. No published studies used linked data sources to provide a comprehensive overview of the extent of POA use or harm in Australia. Future research should focus on undertaking longitudinal cohort studies with linked data sources.

Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

Publisher: Springer Science and Business Media LLC

Date: 2013

DOI: 10.1186/1745-6215-14-384

Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?

Publisher: Frontiers Media SA

Date: 19-11-2018

DOI: 10.3389/FPSYT.2018.00578

NEAT (NicotinE As Treatment) Trial: Protocol of a randomised controlled trial of vaporised nicotine products compared with nicotine replacement therapy following discharge from residential withdrawal

Publisher: Cold Spring Harbor Laboratory

Date: 16-05-2022

DOI: 10.1101/2022.05.15.22275118

Abstract: Tobacco smoking rates in alcohol and other drug (AOD) treatment settings is much higher than in the general Australian population. As a result, people seeking treatment for AOD use experience a greater tobacco-related burden of illness. Attempts to reduce smoking rates in AOD treatment consumers have failed to identify smoking cessation strategies with long term effectiveness. The primary aim of this study is to examine the effectiveness of nicotine vaporised products (NVPs) or nicotine replacement therapy (NRT)on self-reported 6 months continuous abstinence at the 9-month follow-up (6 months following end-of 12 weeks of nicotine treatment) for people leaving smoke-free residential withdrawal treatment. Both groups will also receive Quitline telephone counselling. Secondary outcomes and process measures will also be collected. A two-arm, single-blinded, parallel-group randomised trial with a 6-month post-intervention follow-up (9 months following baseline) will be conducted. The setting is five residential and inpatient government-funded AOD withdrawal units across three cities in three states of Australia (New South Wales, Queensland, Victoria). Participants will be service users aged 18 years or over who smoked at least 10 cigarettes per day, interested in quitting in the next 30 days and have capacity to give informed consent. Research assistants will recruit participants during intake, who then complete a baseline survey, will be randomised to a condition, and receive their first Quitline call during AOD treatment. At discharge, all participants receive a discharge pack containing either NVPs or NRT, depending on condition allocation. This is the first study we know of that will be testing intervening with a tobacco smoking cessation approach during the transition phase from AOD treatment to community. From a public health perspective, this approach has the potential to have tremendous reach into a priority population for smoking cessation. Australian and New Zealand Clinical Trials Registry (ACTRN12619001787178)

How does a family history of psychosis influence the risk of methamphetamine‐related psychotic symptoms: Evidence from longitudinal panel data

Publisher: Wiley

Date: 30-05-2023

DOI: 10.1111/ADD.16230

Abstract: To determine whether the risk of psychotic symptoms during weeks of meth hetamine use was dependent on, increased by, or independent of having a family history of psychosis. Secondary analysis of 13 contiguous 1‐week periods of data (1370 weeks). A risk modification framework was used to test each scenario. Geelong, Wollongong and Melbourne, Australia. Participants in a randomized controlled trial of treatment for meth hetamine dependence ( n = 148) who did not have a primary psychotic disorder on enrolment. Psychotic symptoms in the previous week were defined as a score of 3+ on any of the Brief Psychiatric Rating Scale items of hallucinations, unusual thought content or suspiciousness. Any (vs no) meth hetamine use in the previous week was assessed using the Timeline Followback method. Self‐reported family history of psychosis was assessed using the Diagnostic Interview for Psychosis. The risk of psychotic symptoms in the past week was independently associated with meth hetamine use in that week (relative risk [RR] = 2.3, 95% CI = 1.3–4.3) and with having a family history of psychosis (RR = 2.4, 95% CI = 0.9–7.0) the joint risk among participants with a family history of psychosis during weeks when they were using meth hetamine was large (RR = 4.0, 95% CI = 2.0–7.9). There was no significant interaction between a family history of psychosis and meth hetamine use in predicting psychotic symptoms (interaction RR = 0.7 95% CI = 0.3–1.8), but there was a small non‐significant excess risk due to the interaction (0.20 95% CI = −1.63 to 2.03). Among people dependent on meth hetamine, the relative risk of psychotic symptoms during weeks of meth hetamine use does not appear to be dependent on, or increased by, having a family history of psychosis. However, a family history of psychosis does appear to be an independent risk factor that contributes to the absolute risk of psychotic symptoms in this population.

Decreased thalamic volumes in adolescent inhalant users from Korea and Australia

Publisher: Informa UK Limited

Date: 09-05-2014

DOI: 10.3109/15622975.2014.902540

Abstract: Research investigating the impact of inhalant misuse on brain structure suggests abnormalities in subcortical regions. We investigated the association between inhalant misuse and subcortical brain volumes in adolescents. Based on a collaborative dataset from South Korea (inhalant users: N = 15, mean age = 16.7, SD = 1.1 controls: N = 15, mean age = 15.4, SD = 1.2) and Australia (inhalant users: N = 7, mean age = 18.2, SD = 1.4 controls: N = 7, mean age = 18.9, SD = 2.6), the volumes of caudate nucleus, putamen, pallidum, amygdala, hippoc us, and thalamus were estimated in adolescent inhalant users and healthy adolescents using FreeSurfer. The results revealed a significantly decreased right thalamic volume in adolescent inhalant users (P = 0.042), along with a trend-level decrease in left thalamic volume (P = 0.061). A negative correlation (r = -0.544 P = 0.036) between thalamic volume and severity of inhalant use (i.e., reduced volumes associated with greater use) was identified among Korean participants. These findings suggest that compared with other subcortical structures, the thalamus is particularly sensitive to damage following chronic inhalant exposure during adolescence.

Childhood maltreatment and psychopathology affect brain development during adolescence

Publisher: Elsevier BV

Date: 09-2013

DOI: 10.1016/J.JAAC.2013.06.007

Abstract: The hippoc us and amygdala have received much attention with regard to the deleterious effects of childhood maltreatment. However, it is not known if and when these effects emerge during adolescence and whether comorbid psychopathology is more likely to explain these effects. This study investigated whether childhood maltreatment was associated with hippoc al and amygdala development from early to midadolescence and whether the experience of psychopathology during this period mediated the relation. One hundred seventeen (60 male) adolescents, recruited as part of a broader adolescent development study, participated in magnetic resonance imaging assessments during early and midadolescence (mean age at baseline 12.62 years, SD 0.44 years mean follow-up period 3.78 years, SD 0.20 years), and completed self-report measurements of childhood maltreatment and diagnostic interviews assessing DSM-IV mental disorders. Childhood maltreatment was associated with larger baseline left hippoc al volumes and retarded growth of the left amygdala over time and was indirectly associated, through the experience of psychopathology, with retarded growth of the left hippoc us and accelerated growth of the left amygdala over time. Exploratory cortical analysis showed that maltreatment influenced thickening of the superior parietal region through the experience of psychopathology. Childhood maltreatment was associated with altered brain development during adolescence. The experience of Axis I psychopathology during adolescence may be one mechanism by which childhood maltreatment has continuing effects on brain development during the adolescent years. These findings highlight the importance of early intervention for in iduals who have experienced childhood maltreatment.

The prevalence and determinants of problem gambling in Australia: Assessing the impact of interactive gambling and new technologies.

Publisher: American Psychological Association (APA)

Date: 09-2014

DOI: 10.1037/A0036207

Abstract: New technology is changing the nature of gambling with interactive modes of gambling becoming putatively associated with higher rates of problem gambling. This paper presents the first nationally representative data on the prevalence and correlates of problem gambling among Australian adults since 1999 and focuses on the impact of interactive gambling. A telephone survey of 15,006 adults was conducted. Of these, 2,010 gamblers (all interactive gamblers and a randomly selected subs le of those reporting land-based gambling in the past 12 months) also completed more detailed measures of problem gambling, substance use, psychological distress, and help-seeking. Problem gambling rates among interactive gamblers were 3 times higher than for noninteractive gamblers. However, problem and moderate risk gamblers were most likely to attribute problems to electronic gaming machines and land-based gambling, suggesting that although interactive forms of gambling are associated with substantial problems, interactive gamblers experience significant harms from land-based gambling. The findings demonstrate that problem gambling remains a significant public health issue that is changing in response to new technologies, and it is important to develop strategies that minimize harms among interactive gamblers.

Mental health screening among injecting drug users outside treatment settings – implications for research and health services

Publisher: Informa UK Limited

Date: 06-2008

DOI: 10.1080/17523280802020156

Benzodiazepine use of community-based violent offenders: a preliminary investigation

Publisher: Informa UK Limited

Date: 06-07-2017

DOI: 10.1080/14659891.2016.1195893

Combined Alcohol and Energy Drink Use: Motivations as Predictors of Consumption Patterns, Risk of Alcohol Dependence, and Experience of Injury and Aggression

Publisher: Wiley

Date: 20-05-2014

DOI: 10.1111/ACER.12438

Abstract: Coconsumption of alcohol with energy drinks (AED) is becoming increasingly popular among adolescents and young adults and has been associated with a range of harms. Motivations related to determined drunkenness and hedonistic drinking are potentially important in explaining both alcohol and AED consumption, given that a relationship has been identified between AED use and heavy alcohol consumption. This study aimed to explore motives for combined AED consumption, as well as their relationship with alcohol dependence and experiences of harm and aggression. Students (n = 594) enrolled at Deakin University, Victoria, Australia, completed an anonymous online survey in 2012. Approximately two-thirds of the s le (66.5%) were female, and the mean age was 22.3 (SD = 4.5), consistent with 2012 Deakin University enrollment. Principal axis factor analysis of 14 items measuring motivations for AED use identified 4 factors, categorized as "hedonistic," "social," "energy/endurance," and "intoxication-reduction" motives. Multinomial and binary logistic regression analyses demonstrated that hedonistic motives for AED use significantly predicted increases in alcohol and energy drink coconsumption during AED episodes, risk of alcohol dependence, as well as experiencing harm and aggression. Intoxication-reduction motives significantly predicted harm outcomes. Hedonistic motives specific to sensation and pleasure ideals are implicated in negative consequences associated with coconsumption of alcohol and energy drinks. Further, consumers who reported using AEDs to reduce alcohol intoxication were at increased risk of negative outcomes, a finding indicating that consumer knowledge of the effects of AED use may be limited.

Exploring the Focus and Experiences of Smartphone Applications for Addiction Recovery

Publisher: Informa UK Limited

Date: 07-2013

DOI: 10.1080/10550887.2013.824331

Abstract: Addiction recovery Smartphone applications (apps) (n = 87) identified on the Google Play store in 2012 were coded, along with app user reviews, to explore functions, foci, and user experiences. Content analysis revealed that apps typically provided information on recovery, as well as content to enhance motivation, promote social support and tools to monitor progress. App users commented that the apps helped to inform them, keep them focussed, inspire them, and connect them with other people and groups. Because few addiction recovery apps appear to have been formally evaluated, further research is needed to ascertain their effectiveness as stand-alone or adjunctive interventions.

Feasibility and acceptability of a mental health screening tool and training programme in the youth alcohol and other drug (AOD) sector

Publisher: Wiley

Date: 09-2007

DOI: 10.1080/09595230701499126

Abstract: The high prevalence of co-occurring mental health and substance use disorders in young people is well established. Despite this, there are low rates of detection of co-occurring disorders across alcohol and other drug (AOD) services within Australia. This paper describes the development, implementation and evaluation of a mental health screening tool and training programme within the youth AOD sector. Thirty youth AOD workers received training in mental health screening, and the screening tool was subsequently piloted on 84 young people accessing two youth AOD services. Training was evaluated using measures of the trainee's mental health knowledge, attitudes, skills and confidence in mental health screening at baseline and 12-month follow-up. Feedback from young people supported the feasibility, acceptability and relevance of the screening tool. Evaluation of the associated training programme indicated improvements in AOD workers' mental health knowledge, skills and confidence in mental health screening. These findings provide preliminary evidence of the feasibility and acceptability of the mental health screening tool to young people and the effectiveness of the training package within the youth AOD sector.

A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders

Publisher: Wiley

Date: 26-05-2012

DOI: 10.1111/J.1600-0447.2012.01885.X

Abstract: Excessive alcohol consumption is common among people with psychotic disorders. While there is an extensive literature on the efficacy of psychological treatments for excessive drinking, few studies have examined interventions addressing this issue among people with psychotic disorders. Systematic searches in PubMed and PsycINFO were conducted to identify randomized controlled trials comparing manual-guided psychological interventions for excessive alcohol consumption among in iduals with psychotic disorders. Of the 429 articles identified, seven met inclusion criteria. Data were extracted from each study regarding study s le characteristics, design, results, clinical significance of alcohol consumption results, and methodological limitations. Assessment interviews, brief motivational interventions, and lengthier cognitive behavior therapy have been associated with reductions in alcohol consumption among people with psychosis. While brief interventions (i.e. 1-2 sessions) were generally as effective as longer duration psychological interventions (i.e. 10 sessions) for reducing alcohol consumption, longer interventions provided additional benefits for depression, functioning, and other alcohol outcomes. Excessive alcohol consumption among people with psychotic disorders is responsive to psychological interventions. It is imperative that such approaches are integrated within standard care for people with psychosis.

Family Stress, Well-Being and Hope for the Future When Supporting a Relative with AOD Misuse: A Cross-Sectional Survey

Publisher: Informa UK Limited

Date: 10-09-2021

DOI: 10.1080/01612840.2020.1817207

Insomnia and regulation of sleep-wake cycle with drugs among adolescent risky drinkers

Publisher: American Academy of Sleep Medicine (AASM)

Date: 15-09-2018

DOI: 10.5664/JCSM.7330

Predicting abstinence from methamphetamine use after residential rehabilitation: Findings from the Methamphetamine Treatment Evaluation Study

Publisher: Wiley

Date: 18-04-2017

DOI: 10.1111/DAR.12528

Abstract: We previously found that residential rehabilitation increased continuous abstinence from meth hetamine use 1 year after treatment. We examine what client and treatment characteristics predict this outcome. Participants (n = 176) were dependent on meth hetamine and entering residential rehabilitation for meth hetamine use. Simultaneous logistic regression was used to identify independent predictors of continuous abstinence from meth hetamine use at 1 year follow-up. Measures included demographics, drug use, psychiatric comorbidity (Diagnostic and Statistical Manual of Mental Disorders, major depression, social phobia, panic disorder, schizophrenia, mania and conduct disorder), symptoms of psychosis and hostility, readiness to change, motivations for treatment and treatment characteristics (duration, rapport, group and in idual counselling). Participants stayed in treatment for a median of 8 weeks 23% remained abstinent at 1 year. The only independent predictors of abstinence were more weeks in treatment [adjusted odds ratio (AOR) 1.2, P < 0.001], better rapport with treatment providers (AOR 2.4, P = 0.049) and receipt of in idual counselling (AOR 3.7, P = 0.013), whereas injecting meth hetamine predicted not achieving abstinence (AOR = 0.25, P = 0.002). In idual counselling and good rapport increased abstinence to 45% for injectors, longer stays in treatment (13+ weeks) were additionally needed to produce similar abstinence rates (43%). Abstinence from meth hetamine use following residential rehabilitation could be significantly increased by providing in idual counselling, maintaining good rapport with clients and ensuring longer stays for people who inject the drug. [McKetin R, Kothe A, Baker AL, Lee NK, Ross J, Lubman DI. Predicting abstinence from meth hetamine use after residential rehabilitation: Findings from the Meth hetamine Treatment Evaluation Study. Drug Alcohol Rev 2018 :70-78].

Does SMS improve gambling outcomes over and above access to other e-mental health supports? A feasibility study

Publisher: Informa UK Limited

Date: 11-2017

DOI: 10.1080/14459795.2017.1388831

Hostility Among Methamphetamine Users Experiencing Psychotic Symptoms

Publisher: Wiley

Date: 06-05-2008

DOI: 10.1080/10550490802019816

Abstract: The aim of the study was to provide empirical data on the severity of hostility among meth hetamine users experiencing psychotic symptoms. Participants were 71 meth hetamine users from the general community who had experienced positive psychotic symptoms in the past year. Psychotic symptoms were defined as a score of 4 or greater on the Brief Psychiatric Rating Scale (BPRS) subscales of suspiciousness, unusual thought content, or hallucinations. The BPRS hostility subscale was used to measure hostility during the most severe symptom episode during the preceding year. Pathological hostility (BPRS score of 4+) was reported by 27% of participants during their most severe episode of psychotic symptoms. Hostility was significantly more common among participants experiencing severe psychotic symptoms (BPRS score 6-7, 42% vs. 15%) or where the psychotic symptoms continued for at least two days (43% vs. 20%). Daily heroin use and low levels of schooling were also correlated with hostility. Clinically significant hostility co-occurs with psychotic symptoms in around one-quarter of meth hetamine users who experience psychosis, and it is more common with severe psychotic symptoms that persist for longer than two days.

Coping style and ecstasy use motives as predictors of current mood symptoms in ecstasy users

Publisher: Elsevier BV

Date: 10-2013

DOI: 10.1016/J.ADDBEH.2013.05.005

Abstract: Elevated depressive and anxiety symptoms during childhood and adolescence have been associated with greater risk of later ecstasy use. Ecstasy users have reported using ecstasy to reduce depression or worry, or to escape. While these findings suggest that some people use ecstasy as a form of self-medication, limited research has been conducted examining the relationship between affective symptoms, coping styles and drug use motives in ecstasy users. This cross-sectional study aimed to determine if coping style and/or ecstasy use motives are associated with current mood symptoms in ecstasy users. A community s le (n=184) of 18-35 year olds who had taken ecstasy at least once in the past 12 months completed self-report measures of depression, anxiety, ecstasy use motives and coping styles. Timeline follow back methods were used to collect information on lifetime ecstasy, recent drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview-Trauma List. Coping motives for ecstasy use and an emotion-focused coping style were significantly associated with current depressive and anxiety symptoms. Emotion-focused coping mediated the relationship between a history of trauma and current anxiety symptoms and moderated the relationship between recent stressful life events and current depressive symptoms. These findings highlight the importance of interventions targeting motives for ecstasy use, and providing coping skills training for managing stressful life events among people with co-occurring depressive/anxiety symptoms and ecstasy use.

A school-based health promotion programme to increase help-seeking for substance use and mental health problems: study protocol for a randomised controlled trial

Publisher: Springer Science and Business Media LLC

Date: 08-08-2016

DOI: 10.1186/S13063-016-1510-2

An Exploratory RCT to Support Gamblers’ Intentions to Stick to Monetary Limits: A Brief Intervention Using Action and Coping Planning

Publisher: Springer Science and Business Media LLC

Date: 13-07-2019

DOI: 10.1007/S10899-019-09873-W

Abstract: The aim of this study was to investigate the feasibility and impact of an action and coping planning intervention deployed in gambling venues to improve adherence to expenditure limits. We conducted a 2-group parallel-block randomised controlled trial comparing one 20-min session of action and coping planning to an assessment alone. Gamblers who were intending to set a monetary limit on EGMs (n = 184) were recruited in venues and administered the intervention prior to gambling. Measures were adherence to self-identified gambling limits and adherence to expenditure intentions at 30-days post-intervention using the Time Line Follow-Back. The intervention was feasible in terms of recruitment and willingness of gamblers to engage in a pre-gambling intervention. Most gamblers enacted strategies to limit their gambling prior to entering the venue, albeit these limits were on average higher than the Australian low risk gambling guidelines. In terms of impact, the intervention did not improve adherence to limits at post or 30-day follow-up assessment. However, Moderate Risk/Problem Gamblers in the Intervention group spent less (a median of $60 less) than intended (median $100) within the venue. All intervention participants intended to spend significantly less in the 30 days after the intervention compared to the amount spent in the 30 days prior to the intervention. This reduction was not found for participants in the control group. A simple brief intervention appears feasible in gambling venues and have an impact on gambling intentions over the short term.

A systematic review of diffusion weighted MRI studies of white matter microstructure in adolescent substance users

Publisher: Elsevier BV

Date: 09-2013

DOI: 10.1016/J.NEUBIOREV.2013.06.015

Abstract: Recent studies using diffusion weighted magnetic resonance imaging (DW-MRI) have provided evidence of abnormal white matter microstructure in adults with substance use disorders (SUDs). While there is a growing body of research using DW-MRI to examine the impact of heavy substance use during adolescence, this literature has not been systematically reviewed. Online databases were searched for DW-MRI studies of adolescent substance users, and 10 studies fulfilled the inclusion and exclusion criteria. We identified consistent evidence for abnormal white matter microstructure in neocortical association pathways as well as in projection and thalamic pathways. Dose-dependent relationships between DW-MRI measures and patterns of substance use were also observed. The consistency of these findings with DW-MRI research in adults suggests that white matter microstructure is impacted in the early stages of heavy substance use. However, given the largely cross-sectional nature of the available data, important questions remain regarding the extent to which white matter abnormalities are a consequence of adolescent exposure to alcohol and other drugs of abuse or reflect pre-existing differences that increase risk for SUDs.

Cognitive deficits in methamphetamine addiction: Independent contributions of dependence and intelligence

Publisher: Elsevier BV

Date: 04-2020

DOI: 10.1016/J.DRUGALCDEP.2020.107891

MAKINGtheLINK: A school-based intervention to improve help-seeking for substance use problems

Publisher: Wiley

Date: 17-02-2017

DOI: 10.1111/EIP.12402

Abstract: Many young people are reluctant to seek professional help for alcohol and other substance use problems, preferring to rely on family and friends. MAKINGtheLINK is a school-based intervention that teaches adolescents how to help their peers overcome barriers to engaging with professional help. The current study examined the effect of the MAKINGtheLINK programme in a s le of 12- to 15-year-old students. Participants included 247 Grade 8 students (49% male, 51% female) recruited from 3 schools in Victoria, Australia. Participants completed questionnaires measuring barriers to professional help-seeking, help-seeking intentions and confidence to seek help at 3 time points (pre-intervention, post-intervention and 6-week follow-up). A non-controlled repeated measures design was used to assess the effect of the programme on help-seeking across time points. The programme decreased barriers, increased intentions to seek help from formal sources, decreased intentions to seek help from family and increased confidence to seek help for a peer. The decrease in barriers was maintained at the 6-week follow-up, as were decreased intentions to seek help from family members, and increased intentions to seek help from school counsellors and alcohol and drug workers. The effects of the intervention did not differ substantially between males and females. The MAKINGtheLINK is the first intervention to focus on overcoming barriers to help-seeking for substance use problems by helping adolescents develop skills to support their peers. The intervention has promise as a means of facilitating help-seeking during adolescence, although further research is needed to test its effectiveness in a more rigorous design.

Therapeutic alliance and change in psychiatric symptoms in adolescents and young adults receiving drug treatment

Publisher: Informa UK Limited

Date: 2008

DOI: 10.1080/14659890802092063

The association between regular cannabis exposure and alterations of human brain morphology: An updated review of the literature

Publisher: Bentham Science Publishers Ltd.

Date: 31-05-2014

DOI: 10.2174/13816128113199990435

Abstract: Cannabis is the most widely used illicit drug worldwide, though it is unclear whether its regular use is associated with persistent alterations in brain morphology. This review examines evidence from human structural neuroimaging investigations of regular cannabis users and focuses on achieving three main objectives. These include examining whether the literature to date provides evidence that alteration of brain morphology in regular cannabis users: i) is apparent, compared to non-cannabis using controls ii) is associated with patterns of cannabis use and with iii) measures of psychopathology and neurocognitive performance. The published findings indicate that regular cannabis use is associated with alterations in medial temporal, frontal and cerebellar brain regions. Greater brain morphological alterations were evident among s les that used at higher doses for longer periods. However, the evidence for an association between brain morphology and cannabis use parameters was mixed. Further, there is poor evidence for an association between measures of brain morphology and of psychopathology symptoms/neurocognitive performance. Overall, numerous methodological issues characterize the literature to date. These include investigation of small s le sizes, heterogeneity across studies in s le characteristics (e.g., sex, comorbidity) and in employed imaging techniques, as well as the examination of only a limited number of brain regions. These factors make it difficult to draw firm conclusions from the existing findings. Nevertheless, this review supports the notion that regular cannabis use is associated with alterations of brain morphology, and highlights the need to consider particular methodological issues when planning future cannabis research.

Correlates of transient versus persistent psychotic symptoms among dependent methamphetamine users

Publisher: Elsevier BV

Date: 04-2016

DOI: 10.1016/J.PSYCHRES.2016.02.038

Abstract: This study examined correlates of transient versus persistent psychotic symptoms among people dependent on meth hetamine. A longitudinal prospective cohort study of dependent meth hetamine users who did not meet DSM-IV criteria for lifetime schizophrenia or mania. Four non-contiguous one-month observation periods were used to identify participants who had a) no psychotic symptoms, (n=110) (b) psychotic symptoms only when using meth hetamine (transient psychotic symptoms, n=85) and, (c) psychotic symptoms both when using meth hetamine and when abstaining from meth hetamine (persistent psychotic symptoms, n=37). Psychotic symptoms were defined as a score of 4 or greater on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content. Relative no psychotic symptoms, both transient and persistent psychotic symptoms were associated with childhood conduct disorder and comorbid anxiety disorders. Earlier onset meth hetamine use and being male were more specifically related to transient psychotic symptoms, while a family history of a primary psychotic disorder and comorbid major depression were specifically related to persistent psychotic symptoms. We conclude that there are overlapping but also distinct clinical correlates of transient versus persistent psychotic symptoms, suggesting potentially heterogeneous etiological pathways underpinning the psychotic phenomena seen amongst people who use meth hetamine.

Gross morphological brain changes with chronic, heavy cannabis use

Publisher: Royal College of Psychiatrists

Date: 2015

DOI: 10.1192/BJP.BP.114.151407

Abstract: We investigated the morphology of multiple brain regions in a rare s le of 15 very heavy cannabis users with minimal psychiatric comorbidity or significant exposure to other substances (compared with 15 age- and IQ-matched non-cannabis-using controls) using manual techniques. Heavy cannabis users demonstrated smaller hippoc us and amygdala volumes, but no alterations of the orbitofrontal and anterior- and paracingulate cortices, or the pituitary gland. These findings indicate that chronic cannabis use has a selective and detrimental impact on the morphology of the mediotemporal lobe.

Combining approach bias modification with working memory training during inpatient alcohol withdrawal: An open-label pilot trial of feasibility and acceptability

Publisher: Springer Science and Business Media LLC

Date: 06-06-2019

DOI: 10.1186/S13011-019-0209-2

Considerations when selecting pharmacotherapy for nicotine dependence.

Publisher: Informa UK Limited

Date: 29-11-2019

DOI: 10.1080/14656566.2018.1550072

Conn's dementia

Publisher: Elsevier BV

Date: 06-2002

DOI: 10.1016/S1474-4422(02)00045-5

Health service utilisation attributable to methamphetamine use in Australia: Patterns, predictors and national impact

Publisher: Wiley

Date: 12-03-2018

DOI: 10.1111/DAR.12518

Abstract: We estimated health service utilisation attributable to meth hetamine use, its national impact and examined other predictors of health service utilisation among dependent meth hetamine users. Past year rates of health service utilisation (number of attendances for general hospitals, psychiatric hospitals, emergency departments, general practitioners, psychiatrists, counsellors or psychologists, and dentists) were estimated for three levels of meth hetamine use (no use, < weekly, ≥ weekly) using panel data from a longitudinal cohort of 484 dependent meth hetamine users from Sydney and Brisbane, Australia. Marginal rates for meth hetamine use were multiplied by 2013 prevalence estimates from the National Drug Strategy Household Survey. Covariates included other substance use, demographics, mental disorders and drug treatment. Health service use was high. More frequent meth hetamine use was associated with more frequent presentations to emergency departments (incidence rate ratios 1.3-2.1) and psychiatric hospitals (incidence rate ratios 5.3-8.3) and fewer presentations to general practitioners, dentists and counsellors. We estimate meth hetamine use accounted for between 28 400 and 80 900 additional psychiatric hospital admissions and 29 700 and 151 800 additional emergency department presentations in 2013. More frequent presentations to these services were also associated with alcohol and opioid use, comorbid mental health disorders, unemployment, unstable housing, attending drug treatment, low income and lower education. Frequent meth hetamine use has a significant impact on emergency medical and psychiatric services. Better provision of non-acute health care services to address the multiple health and social needs of dependent meth hetamine users may reduce the burden on these acute care services. [McKetin R, Degenhardt L, Shanahan M, Baker AL, Lee NK, Lubman DI. Health service utilisation attributable to meth hetamine use in Australia: patterns, predictors and national impact. Drug Alcohol Rev 2017 :000-000].

Determining the Impact of Opioid Policy on Substance Use and Mental Health–Related Harms: Protocol for a Data Linkage Study (Preprint)

Publisher: JMIR Publications Inc.

Date: 14-08-2023

DOI: 10.2196/PREPRINTS.51825

Abstract: ncreasing harms related to prescription opioids over the past decade have led to the introduction of a range of key national and state policy initiatives across Australia. These include introducing a mandatory real-time prescription drug monitoring program (PDMP) in the state of Victoria from April 2020, and a series of changes to subsidies for opioids on the Pharmaceutical Benefit Scheme from June 2020. Together, these changes aim to influence opioid supply and reduce harms related to prescription opioids, yet few studies have specifically explored how these policies have influenced opioid prescribing and related harms in Australia. he aim of this study is to examine the impact of a range of opioid-related policies on hospital admissions and emergency department (ED) presentations, in Victoria, Australia. In particular, the study aims to understand the effect of various opioid policy and opioid prescribing changes on: (1) The number and rates of ED presentations and hospital admissions attributed to substance use (i.e opioid and non-opioid related), or mental ill-health (e.g., suicide, self-harm, anxiety, depression) (2) The association between differing opioid dose trajectories and the likelihood of ED presentations and hospital admissions related to substance use and mental ill-health and (3) Whether changes in an in idual’s opioid prescribing changes the risk related to ED presentations and hospital admissions related to substance use and mental ill-health. his is a population-level linked data study. General practice health records obtained from the Population Level Analysis and Reporting (POLAR) platform are linked with person-level data from three large hospital networks in Victoria, Australia. Interrupted time series (ITS) analysis will be used to examine the impact of opioid policies on a range of harms including the rates of presentations related to substance use (opioid and non-opioid), and mental ill-health among the primary care cohort. Group-based trajectory modelling and a case-crossover design will be used to further explore the impact of changes in opioid dosage and other covariates on opioid and non-opioid poisonings, and mental ill-health related presentations at the patient-level. iven that this paper serves as a protocol, there are currently no results available. The de-identified primary health data was sourced from electronic medical records of ~4,717,000 patients from 542 consenting general practices over a 6-year period (2017-2022). Submission of results for publication is planned for early 2024. his study will add to the limited evidence base to help understand the impact of opioid policies in Australia, including if intended or unintended outcomes are occurring as a result. Ethics approval has been obtained from the Monash University Human Research Ethics Committee (ID 76744), Monash Health (RES-22-0000-026A), Peninsula Health (SSA/76744/PH-2022), and Eastern Health (S22-032-76744). rotocol registration details EU PAS Register (EUPAS104005)

Commentary on Salom et al. (2016): Early onset substance use—a key target for prevention and early intervention

Publisher: Wiley

Date: 16-12-2015

DOI: 10.1111/ADD.13188

Characteristics of oxycodone‐related ambulance attendances: analysis of temporal trends and the effect of reformulation in Victoria, Australia from 2013 to 2018

Publisher: Wiley

Date: 04-01-2021

DOI: 10.1111/ADD.15365

Abstract: In Australia, oxycodone has been associated with increasing rates of harm over time, despite reduced use, reformulation to a t er‐resistant form and in contrast to most prescription opioids. We explored characteristics of oxycodone‐related ambulance attendances to understand whether presentation characteristics could explain increasing oxycodone harm. Retrospective study of coded ambulance patient care records related to extramedical oxycodone use, January 2013 to September 2018. Victoria, Australia. A total of 2788 oxycodone‐related ambulance attendances. Primary outcomes were temporal changes in characteristics of oxycodone presentations over time (from 2013 to 2018) and following reformulation. Covariates include demographic characteristics, presentation severity, mental health, substance use and poisoning intent. Average age was 41.3 (± 16.4) years with females comprising 56.4% of attendances ( n = 2788). The proportion of females in oxycodone‐related attendances increased over time [an average increase in the odds ratios of 5% per year (OR) = 1.05, 95% confidence interval (CI) = 1.01–1.10]. Other temporal trends included a reduced likelihood of naloxone administration (OR = 0.92, 95% CI = 0.85–1.00), heroin involvement (OR = 0.81, 95% CI = 0.66–0.99), comorbid mental health symptoms (OR = 0.87, 95% CI = 0.82–0.92) and unknown intent poisoning (OR = 0.91, 95% CI = 0.85–0.96) and a greater risk of alcohol involvement (OR = 1.06, 95% CI = 1.01–1.11), non‐opioid extramedical pharmaceutical use (OR = 1.05, 95% CI = 1.01–1.10), comorbid suicidal thoughts or behaviours (OR = 1.10, 95% CI = 1.05–1.15) and past history of psychiatric issues (OR = 1.22, 95% CI = 1.16–1.27). Interrupted time–series analysis showed that reformulation was associated with an immediate effect on sex, severity, accidental poisoning and unknown intent poisoning, although these were not sustained over time. Alcohol involvement in the attendance (OR = 1.43, 95% CI = 1.17–1.74, i.e. an average increase in the odds of 43% per year), Glasgow Coma Scale (OR = 1.28, 95%CI 1.04 – 1.57), a previous history of psychiatric issues (OR = 0.80, 95% CI = 0.70–0.92, i.e. an average decrease in the odds of 20% per year, heroin involvement (OR = 0.22, 95% CI = 0.05 – 0.98) and illicit drug use (OR = 0.45, 95% CI = 0.23 – 0.87) showed statistically significant relative changes following the reformulation. The characteristics of oxycodone presentations in Australian ambulances attendances appear to be changing over time, including more female presentations increasing alcohol use, extramedical use of non‐opioid pharmaceuticals and suicidal thoughts or behaviours and decreasing heroin and illicit drug involvement.