ORCID Profile
0000-0002-6792-916X
Current Organisation
Leeds Trinity University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Health, Clinical and Counselling Psychology | Public Health and Health Services not elsewhere classified | Studies in the Creative Arts and Writing not elsewhere classified | Public Health and Health Services
ANZSRC Socio-Economic Objective (SEO)
Specific Population Health (excl. Indigenous Health) not elsewhere classified | Community Service (excl. Work) not elsewhere classified |
Related Links
Publications
Time of day of methadone consumption and illicit heroin use
Publisher: Elsevier BV
Date: 12-1997
DOI: 10.1016/S0376-8716(97)00138-5
Abstract: One hundred clients receiving methadone substitution treatment participated in an investigation of the relationship between methadone dose, time of daily self-administration and reported illicit heroin and other drug use. The study was conducted at two outpatient clinics operating from a single site at the Maudsley Hospital, London. Forty-seven per cent of clients reported using illicit heroin on one or more occasions in the week before interview. Multivariate analysis of methadone dose, time of methadone administration and duration of treatment indicated that the time of methadone administration was the most important predictor of illicit heroin use. Clients who took their methadone before 1500 h were less likely to use heroin than those who consumed methadone later in the day. This finding suggests the possibility of reducing illicit heroin use by methadone maintenance clients through the structuring of treatment programmes so that supervision of methadone consumption occurs during the early part of the day.
The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome
Publisher: Wiley
Date: 12-1998
DOI: 10.1046/J.1360-0443.1998.9312185711.X
Abstract: To develop a brief, multi-dimensional instrument for assessing treatment outcome for people with drug and/or alcohol problems. The Maudsley Addiction Profile (MAP) is the first instrument to be developed in the United Kingdom for this purpose. Field testing with quota-recruitment of problem drug users and problem alcohol users in treatment with researcher and clinician-administered test-retest interviews. Two community and two inpatient services at the Bethlem Royal and Maudsley Hospital, London. Subjects (160 drug users and 80 alcohol users) interviewed by eight interviews (four researchers and four clinicians), each of whom interviewed 30 subjects on two occasions. Sixty items across substance use, health risk, physical sychological health and personal/social functioning domains. Average completion time of the MAP was 12 minutes. The questionnaire was acceptable to a majority of subjects and performed well with both researcher and clinician interviewers. Internal reliability and feasible concurrent validity assessments of the scales and items were highly satisfactory. Test-retest reliability was good, average intraclass correlation coefficients across eight substances were 0.94 and 0.81 across health risk, health problems, relationship conflict, employment and crime measures. The MAP can serve as a core research instrument with additional outcome measures added as required. The collection of a set of reliable quantitative measures of problems among drug and alcohol users by research or treatment personnel for outcome evaluation purposes need not be time-consuming.
Benzodiazepine use and aggressive behaviour: A systematic review
Publisher: SAGE Publications
Date: 02-09-2014
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.
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
Dual diagnosis screening: preliminary findings on the comparison of 50 clients attending community mental health services and 50 clients attending community substance misuse services
Publisher: Informa UK Limited
Date: 2002
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
Composition of social networks to build recovery capital differ across early and stable stages of recovery
Publisher: Informa UK Limited
Date: 27-07-2023
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
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.
Cognitive impairment in dual diagnosis inpatients with schizophrenia and alcohol use disorder
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.SCHRES.2009.05.020
Abstract: Cognitive impairment has been found independently among in iduals with schizophrenia and in iduals with alcohol use disorders. Less is known about the nature and severity of cognitive impairment in patients with a dual diagnosis, though the co-occurrence of these disorders may further exacerbate cognitive impairment. The study investigates the possible additive effect of alcohol use disorder and schizophrenia on cognitive impairment among patients diagnosed with schizophrenia. Participants were inpatients with schizophrenia (n=30), inpatients with a dual diagnosis of schizophrenia and alcohol use disorder (n=30), and matched controls (n=30): all completed a comprehensive neuropsychological battery. Both patient groups were significantly impaired, relative to controls, across the battery. Dual diagnosis patients were significantly more impaired than schizophrenia patients on delayed verbal memory, and executive functioning, primarily set-shifting, working memory, and planning, and had higher psychiatric morbidity scores. The findings provide support for an additive effect of the two disorders on cognitive impairment. These cognitive deficits may affect capacity to engage in treatment, increase risk of relapse, and adversely affect treatment outcomes. An understanding of the cognitive profile of people with dual diagnosis may help to tailor treatment delivery to meet their specific needs, enhance cognitive strengths, accommodate deficits and improve treatment outcomes.
Screening for cognitive functioning in psychiatric outpatients with schizophrenia, alcohol dependence, and dual diagnosis
Publisher: Elsevier BV
Date: 03-2007
DOI: 10.1016/J.SCHRES.2006.11.019
Abstract: Cognitive impairment is common to both schizophrenia and alcoholism. Despite increasing recognition that people with both disorders represent a problematic client group, little is known about the possible additive effect of a dual diagnosis upon impaired cognitive function. This study investigates impairment of cognitive functioning in patients with schizophrenia, alcohol dependence, or a dual diagnosis of schizophrenia and alcohol use disorder. It was hypothesised that patients with dual diagnosis would show greater cognitive impairment than those with a single diagnosis. The Mini-Mental State Examination (MMSE) and standardised measures of psychiatric health and substance use were administered to 120 community psychiatric patients with a diagnosis of schizophrenia, alcohol dependence and both conditions (dual diagnosis). Higher rates of cognitive impairment were found among dual diagnosis patients compared to the schizophrenia or alcohol patients. This was shown in age-adjusted measures of global functioning, and on the tests of language, reading and writing, and visuospatial construction. Despite its common usage, global MMSE scores were insensitive to the cognitive impairments typically found in these clinical groups. Where the MMSE is used as a screening tool, it is recommended that scores are adjusted for the effects of age.
Benzodiazepine use of community-based violent offenders: a preliminary investigation
Publisher: Informa UK Limited
Date: 06-07-2017
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.
Applying the social identity approach in clinical and health domains: Key principles and insights
Publisher: Routledge
Date: 10-11-2016
Online screening for alcohol and other drug problems: An acceptable method for accessing help
Publisher: AMPCo
Date: 08-2013
DOI: 10.5694/MJA13.10219
Differences in mental health, substance use, and other problems among dual diagnosis patients attending psychiatric or substance misuse treatment services
Publisher: Informa UK Limited
Date: 02-2008
IS ATTENDANCE AT ALCOHOLICS ANONYMOUS MEETINGS AFTER INPATIENT TREATMENT RELATED TO IMPROVED OUTCOMES? A 6-MONTH FOLLOW-UP STUDY
Publisher: Oxford University Press (OUP)
Date: 12-08-2003
Abstract: This study investigates the relationship between attendance at Alcoholics Anonymous (AA) meetings prior to, during, and after leaving treatment, and changes in clinical outcome following inpatient alcohol treatment. A longitudinal design was used in which participants were interviewed at admission (within 5 days of entry), and 6 months following departure. The s le comprised 150 patients in an inpatient alcohol treatment programme who met ICD-10 criteria for alcohol dependence. The full s le was interviewed at admission to treatment. Six months after departure from treatment, 120 (80%) were re-interviewed. Significant improvements in drinking behaviours (frequency, quantity and reported problems), psychological problems and quality of life were reported. Frequent AA attenders had superior drinking outcomes to non-AA attenders and infrequent attenders. Those who attended AA on a weekly or more frequent basis after treatment reported greater reductions in alcohol consumption and more abstinent days. This relationship was sustained after controlling for potential confounding variables. Frequent AA attendance related only to improved drinking outcomes. Despite the improved outcomes, many of the s le had alcohol and psychiatric problems at follow-up. The importance of aftercare has long been acknowledged. Despite this, adequate aftercare services are often lacking. The findings support the role of Alcoholics Anonymous as a useful aftercare resource.
The emergence of a recovery movement for alcohol and drug dependence
Publisher: SAGE Publications
Date: 19-03-2012
Social and transitional identity: exploring social networks and their significance in a therapeutic community setting
Publisher: Emerald
Date: 08-04-2014
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.
Predictors of Flexibility in Social Identity Among People Entering a Therapeutic Community for Substance Abuse
Publisher: Informa UK Limited
Date: 02-01-2015
Development and Implementation of a Structured Intervention for Alcohol Use Disorders for Telephone Helpline Services
Publisher: Informa UK Limited
Date: 02-01-2015
Associations between social identity diversity, compatibility, and recovery capital amongst young people in substance use treatment
Publisher: Elsevier BV
Date: 12-2016
The virtual disappearance of injectable opioids for heroin addiction under the ‘British System’
Publisher: Informa UK Limited
Date: 08-12-2009
Drinking and smoking as concurrent predictors of illicit drug use and positive drug attitudes in adolescents
Publisher: Elsevier BV
Date: 11-2000
DOI: 10.1016/S0376-8716(00)00113-7
Abstract: The study investigates the relationship between smoking and drinking, and the use of illicit drugs in a cohort of London adolescents. A high prevalence of drug experimentation and positive attitudes to illicit drug use were characteristic of those who both drank alcohol and smoked cigarettes on a regular basis. There was then a clear hierarchy in which lower prevalence of use and more negative attitudes marked those who only smoked, then those who only drank, while non-smokers and non-drinkers (the largest group) had lowest lifetime and recent drug use prevalence and the most negative attitudes about drug use.
New estimates of the number of children living with substance misusing parents: results from UK national household surveys
Publisher: Springer Science and Business Media LLC
Date: 08-10-2009
Social identity, social networks and recovery capital in emerging adulthood: A pilot study
Publisher: Springer Science and Business Media LLC
Date: 11-11-2015
Social Identity Mapping in Addiction Recovery (SIM-AR): extension and application of a visual method
Publisher: Informa UK Limited
Date: 16-01-2019
Can we prevent drug related deaths by training opioid users to recognise and manage overdoses?
Publisher: Springer Science and Business Media LLC
Date: 2009
Drug deaths in police custody: is dual diagnosis a significant factor?
Publisher: Elsevier BV
Date: 08-2004
“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
Ethnic and Gender Differences in Drinking and Smoking among London Adolescents
Publisher: Informa UK Limited
Date: 02-2001
Abstract: The study examines stages of drinking and smoking careers and transitions from initiation to regular use among adolescents, as a function of ethnic status and gender. The data were collected using a confidential, self-completion questionnaire assessing onset and frequency of drinking and smoking. The s le consisted of 1777 adolescents, between the ages of 11 and 14, drawn from eight secondary schools in south-west London. For both smoking and drinking, white children were more likely to have ever smoked tobacco and drunk alcohol, and were also more likely to progress from initiation to regular use than were either black or Asian children. Asian children reported the latest onset and the lowest prevalence rates for both drinking and smoking. Males reported experimenting with both cigarettes and alcohol at an earlier age than females, although a lower proportion of males report regular and lifetime involvement with both alcohol and tobacco. Furthermore, a significantly higher proportion of females who try smoking go on to do so regularly. The importance of sociocultural factors in relation to race and gender in predicting onset and escalation of substance use is discussed. The fact that age of onset does not appear to be a significant determinant of transition rate from initiation to regular use is also explored.
Excessive drinking and other problem behaviours among 14–16 year old schoolchildren
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1016/J.ADDBEH.2005.12.002
Abstract: The study investigates excessive drinking and associations with other problem behaviours in 2078 school students aged 14-16 years in seven London secondary schools. Using a cross-sectional design, a self-completion questionnaire assessed lifetime and recent (past month) alcohol and drug consumption, attitudes to alcohol use education, alcohol-related problems, psychological problems, educational aspirations, truancy, and delinquent behaviour. Excessive drinking was operationally defined as 10 or more units of alcohol per drinking occasion. At least one episode of excessive drinking was reported by 32% of the s le, with 10% reporting five or more episodes. Excessive drinking was positively associated with frequency of cigarette smoking, use of cannabis, positive attitudes towards illicit drugs, low educational aspirations, higher depression scores, frequent truancy, and involvement in delinquent behaviours. Excessive drinking is a problematic behaviour in its own right but it is also a marker for other problem behaviours, including illicit drug misuse and delinquency. Understanding and responding to alcohol misuse among adolescents requires attention to psychological, social and developmental factors other than alcohol consumption alone.
Cannabis use in adolescents: the impact of risk and protective factors and social functioning
Publisher: Wiley
Date: 11-2005
DOI: 10.1080/09595230500292920
Abstract: The study uses a school-based s le to test the social and familial risk and protective factors relating to cannabis use. Based on a self-completion survey of 2078 14-16-year-olds (mean age of 15 years) attending seven standard state-run secondary schools in south London, an assessment was made of rates and risk factors for cannabis use. Twenty-four per cent of the total s le had ever used cannabis, with 15% having done so in the month prior to assessment. In addition to greater likelihood of illicit drug use, lifetime cannabis users were less likely to spend time regularly with both their mothers and fathers, but more likely to spend free time with friends who smoked, drank alcohol and used illicit drugs, and with friends involved in criminal activities. Among those who had ever used cannabis, frequency of cannabis use was predicted (using linear regression) by two onset factors (earlier initiation of drinking and cannabis use were both linked to more frequent use) and two social factors (more time spent with drug-using friends and less time spent with the mother). Overall, the study showed that early onset, itself predicted by social networks, is linked to more frequent use of cannabis and that this appears to be sustained by less time spent with parents and more with drug-using peers.
Gender differences in psychosocial complexity for a cohort of adolescents attending youth-specific substance abuse services
Publisher: Elsevier BV
Date: 09-2016
Adolescent psychological health problems and delinquency among volatile substance users in a school sample in South London
Publisher: Informa UK Limited
Date: 12-2004
Exploring Clinician Attitudes to Addiction Recovery in Victoria, Australia
Publisher: Informa UK Limited
Date: 02-10-2014
Justice capital: A model for reconciling structural and agentic determinants of desistance
Publisher: SAGE Publications
Date: 08-04-2021
DOI: 10.1177/02645505211005018
Abstract: The emerging literature on desistance (and recovery from addictions) has focused on key life-course transitions that can be characterised as the need for jobs (meaningful activities), friends (transitioning to pro-social) and houses (a home free from threat). The term ‘recovery capital’ is used to characterise personal, social and community resources an in idual can draw upon to support their recovery, partly bridging agentic (personal) and structural (community) factors. The development of the concept of ‘justice capital’ furthers this reconciliation, by focusing on resources an in idual can access and the resources that an institution can provide. We build on this by outlining the concept of institutional justice capital (IJC) to examine the role of criminal justice institutions in supporting or suppressing justice capital, particularly for marginalised groups. We use a case study approach, drawing on recent studies in prisons in Australia and the United Kingdom to develop a model of justice capital at an institutional level and discuss how this can shape reform of prisons and can be matched to the needs of offenders. The paper concludes with a discussion of future directions in implementing an IJC model, to deliver a strengths-based approach to promoting desistance and creating a metric for assessing the rehabilitative activities of institutions.
Does prescribing for opiate addiction change after national guidelines? Methadone and buprenorphine prescribing to opiate addicts by general practitioners and hospital doctors in England, 1995–2005
Publisher: Wiley
Date: 09-03-2007
DOI: 10.1111/J.1360-0443.2007.01762.X
Abstract: To assess changes in opiate prescribing (1995-2005) following a decade of national guidelines to address substandard opiate substitution prescribing for heroin addiction. A repeat national survey (1995 and 2005) using random one-in-four s les of all community pharmacies in England, achieving response rates of 75% (1847/2475) in 1995 and 95% (2349/2473) in 2005. Data were obtained on 3732 (1995 data) and 9620 (2005 data) prescriptions dispensed in the preceding month from the 936 and 1463 pharmacies who were currently dispensing. We have measured impact on practice for seven specific recommended changes. Between 1995 and 2005 the number of substitute opiate prescriptions doubled (x 2.03). By 2005, methadone still dominated (down from 97% to 83%), buprenorphine increased (from 1% to 16%) and other opiate medications virtually disappeared. Changes in the direction of national guidelines included: increased daily dose of methadone (from 47.3 mg to 56.3 mg), more frequent dispensing (from 38% to 60% as daily installments), more supervised consumption (from 0% to 36%) and fewer methadone tablets (from 10.9% to 1.8%). Nevertheless, despite the increased mean daily dose, only 41.0% of prescriptions for methadone were for daily doses in the recommended 60-120 mg dose range. Only one change was not in the direction of the national guidelines--the proportion of prescriptions from GPs fell from 41% to 30%, although this still represented an approximate 50% increase in the extent of GP prescribing. Doubling in provision of opiate substitute treatment has occurred, alongside significant improvements in the nature of this treatment. These positive changes have occurred in the direction of six out of seven of the UK national guidelines.
Overdose training and take‐home naloxone for opiate users: prospective cohort study of impact on knowledge and attitudes and subsequent management of overdoses
Publisher: Wiley
Date: 05-09-2008
DOI: 10.1111/J.1360-0443.2008.02314.X
Abstract: To examine the impact of training in overdose management and naloxone provision on the knowledge and confidence of current opiate users and to record subsequent management of overdoses that occur during a 3-month follow-up period. Repeated-measures design to examine changes in knowledge and confidence immediately after overdose management training retention of knowledge and confidence at 3 months and prospective cohort study design to document actual interventions applied at post-training overdose situations. A total of 239 opiate users in treatment completed a pre-training questionnaire on overdose management and naloxone administration and were re-assessed immediately post-training, at which point they were provided with the take-home emergency supply of naloxone. Three months later they were re-interviewed. Significant improvements were seen in knowledge of risks of overdose, characteristics of overdose and appropriate actions to be taken and in confidence in the administration of naloxone. A 78% follow-up rate was achieved (186 of 239) among whom knowledge of both the risks and physical/behavioural characteristics of overdose and also of recommended management actions was well retained. Eighteen overdoses (either experienced or witnessed) had occurred during the 3 months between the training and the follow-up. Naloxone was used on 12 occasions (a trained client's own supply on 10 occasions). One death occurred in one of the six overdoses where naloxone was not used. Where naloxone was used, all 12 resulted in successful reversal. With overdose management training, opiate users can be trained to execute appropriate actions to assist the successful reversal of potentially fatal overdose. Wider provision may reduce drug-related deaths further. Future studies should examine whether public policy of wider overdose management training and naloxone provision could reduce the extent of opiate overdose fatalities, particularly at times of recognized increased risk.
Mapping social identity change in online networks of addiction recovery
Publisher: Informa UK Limited
Date: 27-07-2018
Changes in Neuropsychological Functioning during Alcohol Detoxification
Publisher: S. Karger AG
Date: 2008
DOI: 10.1159/000156479
Abstract: This study investigates changes in neuropsychological functioning during early abstinence from alcohol. 30 alcohol-dependent inpatients were tested at intake (day 4 of admission) and post detoxification (day 26), using a test-retest design. The neuropsychological battery included measures of pre-morbid IQ, full-scale IQ, verbal and non-verbal measures of memory and executive function. IQ was within the normal range at intake and comparable with age-adjusted normative values and there were some impairments in memory and executive function. There were significant increases in performance scores post detoxification in working memory, verbal fluency and verbal inhibition but not in non-verbal executive function tasks (mental flexibility and planning ability). Despite increased scores on tests of verbal and memory skills after 3 weeks of abstinence, complex executive abilities showed little change. These may have a negative impact on engagement and response to treatment and compromise clinical outcomes, heightening the risk of relapse.
Engaging with 12-Step and Other Mutual Aid Groups During and After Treatment: Addressing Workers’ Negative Beliefs and Attitudes through Training
Publisher: Informa UK Limited
Date: 21-06-2016
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.
The role of abstinence and activity in the quality of life of drug users engaged in treatment
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.JSAT.2013.02.010
Abstract: There is increasing interest in understanding factors that enhance the quality of life of substance users in treatment, however limited research has been conducted to date. Measures of physical and psychological health, overall quality of life, drug use, and meaningful activity (education, training or employment) were collected at treatment entry and review in two areas of England as part of routine monitoring. Analysis was performed on an initial s le of 10,470 cases in one site and a more targeted assessment of 783 cases (with repeated measures for 528 of these) in the second site. Women reported lower satisfaction with their physical and psychological health at treatment entry compared with men, but these differences were not present at treatment review. In iduals who reported engagement in meaningful activities had significantly higher quality of life than those that did not. Clients in treatment who reported abstinence and engagement in meaningful activity demonstrated the highest quality of life. A holistic approach to supporting problematic substance users that acknowledges the importance of participation in meaningful activity is likely to be beneficial.
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.
Putting ‘Justice’ in Recovery Capital: Yarning about Hopes and Futures with Young People in Detention
Publisher: Queensland University of Technology
Date: 20-01-2020
Abstract: Aboriginal and Torres Strait Islander young people are over-represented in Australian youth detention centres and the justice system. In contrast to deficit-focused approaches to health and justice research, this article engages with the hopes, relationships and educational experiences of 38 detained youth in Western Australia who participated in a study of screening and diagnosis for fetal alcohol spectrum disorder. We report on a qualitative study that used a ‘social yarning’ approach. While the participants reported lives marred by substance use, crime, trauma and neurodevelopmental disability, they also spoke of strong connections to country and community, their education experiences and their future goals. In line with new efforts for a ‘positive youth justice’ and extending on models of recovery capital, we argue that we must celebrate success and hope through a process of mapping and building recovery capital in the justice context at an in idual and institutional level.
Social group membership before treatment for substance dependence predicts early identification and engagement with treatment communities
Publisher: Informa UK Limited
Date: 09-01-2019
Substance use outcomes following treatment
Publisher: SAGE Publications
Date: 11-07-2017
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.
Continuing the conversation: 30 years of motivational interviewing dissemination
Publisher: Wiley
Date: 07-06-2016
DOI: 10.1111/ADD.13414
A Model for Predicting Clinician Satisfaction with Clinical Supervision
Publisher: Informa UK Limited
Date: 02-01-2014
Retrospective recall of heroin initiation and the impact on peer networks
Publisher: Informa UK Limited
Date: 2007
Social networks and recovery (SONAR): characteristics of a longitudinal outcome study in five therapeutic communities in Australia
Publisher: Emerald
Date: 12-09-2016
Peritectic phase formation kinetics of directionally solidifying Sn-Cu alloys within a broad growth rate regime
Publisher: Elsevier BV
Date: 11-2021
Alcohol, drug and related health and wellbeing issues among young people completing an online screen
Publisher: SAGE Publications
Date: 30-09-2016
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.
Friends matter but so does their substance use: The impact of social networks on substance use, offending and wellbeing among young people attending specialist alcohol and drug treatment services
Publisher: Informa UK Limited
Date: 02-05-2016
Are the Twelve Steps More Acceptable to Drug Users than to Drinkers?
Publisher: S. Karger AG
Date: 2001
DOI: 10.1159/000050719
Abstract: The present study is a cross-sectional interview-based investigation comparing experiences of and attitudes towards Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) in a s le of 200 patients attending inpatient substance misuse detoxification services. Two hundred consecutive admissions were recruited 100 each from one drug and one alcohol in-patient treatment service in which attendance at AA/NA was a voluntary adjunct to a generic treatment programme. Although there were no differences in the history of AA/NA attendance, the drug users (who were on average younger) reported significantly more positive attitudes towards AA/NA, more willingness to attend during their in-patient treatment and greater intention to attend following completion of their detoxification. In particular, despite no differences in spiritual/religious orientation, the drug users reported more positive views of the Twelve Steps. As AA/NA remain popular and accessible forms of substance misuse support, it is critical that we develop a clearer understanding of their impact and of the scope for their integration with generic forms of substance misuse treatment.
Motivational drive and alprazolam misuse: A recipe for aggression?
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.PSYCHRES.2016.04.040
Abstract: Benzodiazepine-related aggression has received insufficient research attention, in particular little is known about the motivational factors which may contribute to the development of this paradoxical response. The revised Reinforcement Sensitivity Theory provides a theoretical framework from which to understand the relevant underlying motivational processes. The current study aimed to identify the role of approach and avoidance motivational tendencies in the occurrence of benzodiazepine-related aggression. Data regarding benzodiazepine and other substance use, approach and avoidance motivation, and general and physical aggressive behaviour were collected via self-report questionnaires. Participants were a convenience s le (n=204) who reported using benzodiazepines in the previous year. Participants were primarily male (62.7%), aged 18-51 years old. Hierarchical multiple regressions indicated that general and physical aggression were predicted by alprazolam use and Drive, a facet of approach motivation. Overall, lower diazepam use significantly predicted higher levels of general aggression. However, when diazepam-preferring participants were examined in isolation of the larger s le (23.5% of s le), problematic (dependent) diazepam use was associated with greater aggression scores, as was dependence risk for alprazolam-preferring participants (39.7% of s le). The findings highlight the importance of motivational factors and benzodiazepine use patterns in understanding benzodiazepine-related aggression, with implications for violent offender rehabilitation.
Alprazolam and wider benzodiazepine misuse in Australia - Sources of supply and evidence of harms
Publisher: SAGE Publications
Date: 03-07-2013
Building addiction recovery capital through online participation in a recovery community
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.SOCSCIMED.2017.09.050
Abstract: This study examines how online participation in a community of recovery contributes to personal journeys of recovery. It investigates whether recovery capital building - as indicated by increased levels and quality of online social interactions - and markers of positive identity development predict retention in a recovery program designed around fostering community involvement for early stage recovery addicts. It was predicted that online participation on the group's Facebook page and positive identity development are associated to retention in the program. To map how participants interact online, social network analysis (SNA) based on naturally occurring online data (N = 609) on the Facebook page of a recovery community was conducted. Computerised linguistic analyses evaluated sentiment of the textual data (capturing social identity markers). Linear regression analyses evaluated whether indicators of recovery capital predict program retention. To illustrate the findings in the context of the specific recovery community, presented are two case studies of key participants who moved from the periphery to the centre of the social network. By conducting in-depth interviews with these participants, personal experiences of engagement in the online community of group members who have undergone the most significant changes since joining the community are explored. Retention in the program was determined by a) the number of comment 'likes' and all 'likes' received on the Facebook page b) position in the social network (degree of centrality) and c) linguistic content around group identity and achievement. Positive online interactions between members of recovery communities support the recovery process through helping participants to develop recovery capital that binds them to groups supportive of positive change.
The relative impact of waiting time and treatment entry on drug and alcohol use
Publisher: Wiley
Date: 2002
DOI: 10.1080/135562101200100607
Abstract: One hundred and twenty-three treatment-seeking substance misusers were recruited to a study assessing the early impact of treatment. Participants were interviewed at treatment entry and 3 and 6 months later, regardless of their treatment status (i.e. including those who had dropped out of treatment), while additional data were obtained from the two assessment interviews carried out prior to the initiation of treatment. Three consistent observations can be applied to both the opiate misuser (n = 61) and problem drinker s les (n = 62): (1) the period of pre-treatment wait (mean of 8 weeks) was characterized by stable patterns of substance misuse with no significant 'spontaneous' improvement in indices of severity of drug or alcohol problems (2) the period immediately following initiation of treatment was associated with substantial reductions in the quantity and frequency of substance use, an effect not influenced by the length of time for treatment initiation (3) these benefits are maintained to 6 months after treatment initiation. The waiting period for treatment initiation does not seem to be characterized by significant changes in drug or alcohol use patterns, at least among those who made it into treatment, with clear and sustained improvements irrespective of the length of treatment wait.
Breaking good: Breaking ties with social groups may be good for recovery from substance misuse
Publisher: Wiley
Date: 11-09-2014
DOI: 10.1111/BJSO.12081
Abstract: According to the Social Identity Model of Identity Change, maintaining social identities and support over time is good for health and well-being, particularly during stressful transitions. However, in this study we explore the circumstances under which maintaining social identities - such as 'substance user' - may be harmful to health, and when a successful transition constitutes identity change, rather than maintenance. This prospective study examined social identities of 132 adults entering a drug and alcohol therapeutic community (TC) at admission, three fortnightly intervals and exit, as well as a representative subs le of 60 participants at follow-up. Repeated measures ANOVA results showed that user identity decreased significantly over time, such that 76% of the s le decreased in user identity strength over the first month in the TC. At the same time, recovery identity ratings increased significantly over time, with 64% of the s le staying the same or increasing their recovery identity ratings over the first month. Identity change, indexed by the change in the difference score between user identity and recovery identity over the treatment period, accounted for 34% of the variance in drinking quantity, 41% of the variance in drinking frequency, 5% of the variance in other drug use frequency, and 49% of the variance in life satisfaction at follow-up, after accounting for initial substance abuse severity and social identity ratings at entry to the TC. The findings indicate that moving from a substance using identity towards a recovery identity constitutes an important step in substance abuse treatment.
Exploring mortality among drug treatment clients: The relationship between treatment type and mortality
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.JSAT.2017.09.001
Abstract: Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment.
Trends in amphetamine‐related harms in Victoria
Publisher: AMPCo
Date: 09-2013
DOI: 10.5694/MJA13.10149
Measuring recovery capital for people recovering from alcohol and drug addiction: a systematic review
Publisher: Informa UK Limited
Date: 18-08-2023
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
Life in Recovery in Australia and the United Kingdom: Do Stages of Recovery Differ Across National Boundaries?
Publisher: Informa UK Limited
Date: 19-07-2018
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.
Sober social networks: The role of online support groups in recovery from alcohol addiction
Publisher: Wiley
Date: 12-11-2018
DOI: 10.1002/CASP.2388
Does active referral by a doctor or 12-Step peer improve 12-Step meeting attendance? Results from a pilot randomised control trial
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.DRUGALCDEP.2012.05.004
Abstract: Active engagement in 12-Step self-help groups (SHG) is associated with improvements in substance use outcomes during and after treatment, yet levels of participation in SHG meetings in the U.K. remain low. An RCT investigating the impact of active referral to SHG, delivered by doctors or 12-Step peers during inpatient treatment on both inpatient and post-treatment meeting attendance was conducted. 151 inpatients with alcohol, opiate, crack-cocaine or benzodiazepine dependence undergoing detoxification, received one of two active referral interventions: 12-Step peer intervention (PI), doctor intervention (DI), or no intervention (NI). 83% of the s le was followed up, 2-3 months following discharge. Active referral interventions significantly increased attendance at 12-Step meetings during inpatient treatment (88% versus 73%, p<.05). Rates of post-discharge meeting attendance were PI=64%, DI=48%, NI=33%, with those in the PI group significantly (OR=3.6 CI=1.3, 9.8) more likely to have attended. Inpatient meeting attenders were three times as likely to have attended meetings post-discharge (59% versus 20%, p<.01), and post-discharge meeting attenders reported significantly higher abstinence rates (60.8% versus 39.2%, p<.05) at follow-up. However, abstinence rates did not differ significantly across intervention groups (44% [PI], 41% [DI] and 36% [NI]). Attendance at 12-Step SHGs is associated with greater rates of abstinence and active referral, especially by 12-Step peers, increases 12-Step SHG attendance rates. However, improved clinical outcomes among attendees might not occur until stronger recovery peer support networks are established. These results show promise for the benefit of incorporating Twelve Step Facilitation into U.K. treatment settings.
Strategies to facilitate integrated care for people with alcohol and other drug problems: a systematic review
Publisher: Springer Science and Business Media LLC
Date: 07-04-2017
What the recovery movement tells us about prefigurative politics
Publisher: Leibniz Institute for Psychology (ZPID)
Date: 24-05-2016
Abstract: The concept of prefigurative politics has re-emerged following recent worldwide uprisings, such as the Occupy movement, to which this concept has been applied. In applying a contemporary analysis to prefigurative politics, we explore the contribution of community-based recovery groups to the recovery movement, a socio-political movement in the fields of mental health and addiction treatment. We argue that collective action in recovery groups is derived from the formation of an opinion-based social identity and results in alternative approaches to unmet needs, creatively addressing these identified needs through the utilisation of personal, social and collective resources within an emerging recovery community. To illustrate our argument, we provide ex les of community-based recovery groups and the approaches they use in addressing the identified needs of their recovery community. We conclude with an analysis of what community-based recovery groups and the wider recovery movement can contribute to a contemporary understanding of prefigurative politics.
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
Wellbeing and coping strategies of alcohol and other drug therapeutic community workers: a qualitative study
Publisher: Emerald
Date: 10-09-2018
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.
Related Organisations
Leeds Trinity University
Location: United Kingdom of Great Britain and Northern Ireland
Sheffield Hallam University
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
Discovery Projects - Grant ID: DP140103579
Start Date: 06-2014
End Date: 09-2017
Amount: $455,000.00
Funder: Australian Research Council
View Funded Activity