ORCID Profile
0000-0001-9914-3324
Current Organisations
Northern Territory Department of Education and Training Alice Springs Region
,
Austin Health
,
Goulburn Valley Health
,
Royal Australasian College of Physicians
,
Royal Australian College of General Practitioners
,
Royal College of Pathologists of Australasia
,
Swinburne University of Technology
,
University of Melbourne Faculty of Arts
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Publications
Medical use of cannabis: an addiction medicine perspective
Publisher: Wiley
Date: 06-2015
DOI: 10.1111/IMJ.12761
Abstract: The use of cannabis for medical purposes, evident throughout history, has become a topic of increasing interest. Yet on the present medical evidence, cannabis-based treatments will only be appropriate for a small number of people in specific circumstances. Experience with cannabis as a recreational drug, and with use of psychoactive drugs that are prescribed and abused, should inform harm reduction in the context of medical cannabis.
The Wanderings of Altjira, Christianity and the Translation of Sacred Words in Central Australia
Publisher: Academia Verlag
Date: 2019
MDMA and methamphetamine: some paradoxical negative and positive mood changes in an acute dose laboratory study
Publisher: Springer Science and Business Media LLC
Date: 12-02-2011
DOI: 10.1007/S00213-011-2184-9
Abstract: This study investigated the acute mood effects of oral MDMA, meth hetamine, and placebo in a double-blind laboratory study. Fifty-two healthy participants comprised abstinent recreational users of stimulant drugs, 27 female and 25 male, mean age 24.8 years. Three test sessions involved acute 100 mg oral 3.4-methylendioxymeth hetamine (MDMA), 0.42 mg/kg oral meth hetamine, and matching placebo. Drug administration was counterbalanced, testing was double-blind, and medical supervision was present throughout. Car-driving performance on a laboratory simulator was assessed after 3 and 24 h, with the findings being presented elsewhere. Positive and negative moods (PANAS self-ratings) were completed before drug administration, 3, 4.5, and 24 h later. Blood s les were taken to monitor drug plasma levels. Following MDMA, there were no significant increases in positive moods, whereas negative moods were significantly higher than under placebo. Meth hetamine led to significant increases in both positive and negative moods. The MDMA findings contrast with the elated moods, typically noted by dance clubbers on Ecstasy. However, they are consistent with some previous laboratory findings, since a wide array of positive and negative mood changes have been demonstrated. One possible explanatory factor was the neutral environmental situation, particularly if a primary action of MDMA is to intensify ongoing psychological states. Other explanatory factors, such as dosage, gender, post-drug timing, neurohormonal aspects, and social factors, are also discussed. In the laboratory, acute meth hetamine led to significantly higher positive moods. However, against expectations, MDMA did not generate a significant increase in positive moods.
When should the driver with a history of substance misuse be allowed to return to the wheel? A review of the substance misuse section of the Australian national guidelines
Publisher: Wiley
Date: 08-2018
DOI: 10.1111/IMJ.13975
Abstract: Assessing fitness to drive in applicants with a historical or current substance use disorder presents a specific clinical challenge. The Australian guidelines require evidence of remission and absence of cognitive change when considering applications for re-licensing driver or in iduals applying to reengage in safety-sensitive work. This paper reviews some of the clinical and biochemical indicators that determine whether a particular person is in 'remission' and meets the criteria for return to driving or other safety-sensitive occupation. It provides an overview of the challenges in establishing an evidence-based approach to determining fitness for safety critical activities. There is no internationally accepted definition of 'remission'. Review of the literature and examination of assessment protocols from other national jurisdictions are available for alcohol and the more important drugs of interest in road safety. Assessing fitness to drive when there is a history of substance misuse and/or substance use disorders is a complex issue that requires assessment of biomarkers, clinical findings and clinical assessment before the person returns to driving. We propose that hair testing provides a reliable and reproducible way to demonstrate remission and provide cost-effective monitoring. Standardised psychological tests could provide a reproducible assessment of the cognitive effects of drug use and suitability to resume driving. We recommend that AustRoads amend the national guidelines to reflect an evidence-based approach to assessing fitness to drive after conviction for offences related to alcohol and drug use.
Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study
Publisher: SAGE Publications
Date: 08-12-2019
Abstract: Previous randomised, double-blind, placebo-controlled studies have shown that Kava (a South Pacific medicinal plant) reduced anxiety during short-term administration. The objective of this randomised, double-blind, placebo-controlled study was to perform a larger, longer-term trial assessing the efficacy and safety of Kava in the treatment of generalised anxiety disorder and to determine whether gamma-aminobutyric acid transporter (SLC6A1) single-nucleotide polymorphisms were moderators of response. The trial was a phase III, multi-site, two-arm, 16-week, randomised, double-blind, placebo-controlled study investigating an aqueous extract of dried Kava root administered twice per day in tablet form (standardised to 120 mg of kavalactones twice/day) in 171 currently non-medicated anxious participants with diagnosed generalised anxiety disorder. The trial took place in Australia. An analysis of 171 participants revealed a non-significant difference in anxiety reduction between the Kava and placebo groups (a relative reduction favouring placebo of 1.37 points p = 0.25). At the conclusion of the controlled phase, 17.4% of the Kava group were classified as remitted (Hamilton Anxiety Rating Scale score 7) compared to 23.8% of the placebo group ( p = 0.46). No SLC6A1 polymorphisms were associated with treatment response, while carriers of the rs2601126 T allele preferentially respond to placebo ( p = 0.006). Kava was well tolerated aside from poorer memory (Kava = 36 vs placebo = 23 p = 0.044) and tremor/shakiness (Kava = 36 vs placebo = 23 p = 0.024) occurring more frequently in the Kava group. Liver function test abnormalities were significantly more frequent in the Kava group, although no participant met criteria for herb-induced hepatic injury. While research has generally supported Kava in non-clinical populations (potentially for more ‘situational’ anxiety as a short-term anxiolytic), this particular extract was not effective for diagnosed generalised anxiety disorder.
Development of a Suicidal Ideation Detection Tool for Primary Healthcare Settings: Using Open Access Online Psychosocial Data
Publisher: Mary Ann Liebert Inc
Date: 04-2017
Abstract: Suicidal patients often visit healthcare professionals in their last month before suicide, but medical practitioners are unlikely to raise the issue of suicide with patients because of time constraints and uncertainty regarding an appropriate approach. A brief tool called the e-PASS Suicidal Ideation Detector (eSID) was developed for medical practitioners to help detect the presence of suicidal ideation (SI) in their clients. If SI is detected, the system alerts medical practitioners to address this issue with a client. The eSID tool was developed due to the absence of an easy-to-use, evidence-based SI detection tool for general practice. The tool was developed using binary logistic regression analyses of data provided by clients accessing an online psychological assessment function. Ten primary healthcare professionals provided advice regarding the use of the tool. The analysis identified eleven factors in addition to the Kessler-6 for inclusion in the model used to predict the probability of recent SI. The model performed well across gender and age groups 18-64 (AUR 0.834, 95% CI 0.828-0.841, N = 16,703). Healthcare professionals were interviewed they recommended that the tool be incorporated into existing medical software systems and that additional resources be supplied, tailored to the level of risk identified. The eSID is expected to trigger risk assessments by healthcare professionals when this is necessary. Initial reactions of healthcare professionals to the tool were favorable, but further testing and in situ development are required.
Effects of Alcohol and Other Drugs on Driver Performance
Publisher: Informa UK Limited
Date: 09-2004
The effects of dexamphetamine on simulated driving performance
Publisher: Springer Science and Business Media LLC
Date: 22-12-2004
DOI: 10.1007/S00213-004-2061-X
Abstract: The number of road fatalities related to the presence of hetamines in drivers has been relatively constant over the past 10 years. However, there remains uncertainty as to the extent that these drugs induce driving impairment, and whether any such impairments translate to an increase in road fatalities. To examine the acute effects of 0.42 mg/kg dex hetamine on simulated driving performance, and to establish which, if any, simulated driving abilities become impaired following dex hetamine administration. A repeated-measures, counter-balanced, double-blind, placebo-controlled design was employed. Twenty healthy volunteers completed two treatment conditions-0.42 mg/kg dex hetamine and placebo. Performance was assessed using a driving simulator task. Blood and saliva s les were obtained prior to the driving tasks and immediately after task completion (120 min and 170 min post-drug administration, respectively). Mean dex hetamine blood concentrations were 83 ng/ml and 98 ng/ml at 120 min and 170 min, respectively. Results indicated a decrease in overall simulated driving ability following dex hetamine administration during the day-time but not the night-time scenario tasks. Contributing to this performance reduction, "incorrect signalling", "failing to stop at a red traffic light" and "slow reaction times" were the behaviours most strongly affected by dex hetamine. The decrease in simulated driving ability observed during the day-time driving tasks are consistent with the perceptual narrowing or tunnel vision that is associated with dex hetamine consumption.
Birth Order and Delinquency: Findings From a Youth Training Centre
Publisher: SAGE Publications
Date: 09-1974
DOI: 10.1177/000486587400700306
Abstract: THE AIM of this study was to carry out a retrospective evaluation of data on admissions to a youth training centre in Victoria, Australia, to determine the relationship between birth order and risk of delinquency. The findings confirmed the results of other studies (e.g. Biles, 1971) that middle children were at greatest risk. Other factors associated with ‘risk’ were large family size and educational retardation.
The acute effects of 3,4-methylenedioxymethamphetamine and d-methamphetamine on human cognitive functioning
Publisher: Springer Science and Business Media LLC
Date: 22-10-2011
DOI: 10.1007/S00213-011-2532-9
Abstract: This study investigated the acute (3-h) and 24-h post-dose cognitive effects of oral 3,4-methylenedioxymeth hetamine (MDMA), d-meth hetamine, and placebo in a within-subject double-blind laboratory-based study in order to compare the effect of these two commonly used illicit drugs on a large number of recreational drug users. Sixty-one abstinent recreational users of illicit drugs comprised the participant s le, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg d-meth hetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. Cognitive performance was assessed during drug peak (3 h) and at 24 h post-dosing time-points. Blood s les were also taken to quantify the levels of drug present at the cognitive testing time-points. Blood concentrations of both meth hetamine and MDMA at drug peak s les were consistent with levels observed in previous studies. The major findings concern poorer performance in the MDMA condition at peak concentration for the trail-making measures and an index of working memory (trend level), and more accurate performance on a choice reaction task within the meth hetamine condition. Most of the differences in performance between the MDMA, meth hetamine, and placebo treatments diminished by the 24-h testing time-point, although some performance improvements subsisted for choice reaction time for the meth hetamine condition. Further research into the acute effects of hetamine preparations is necessary to further quantify the acute disruption of aspects of human functioning crucial to complex activities such as attention, selective memory, and psychomotor performance.
Detecting impairment associated with cannabis with and without alcohol on the Standardized Field Sobriety Tests
Publisher: Springer Science and Business Media LLC
Date: 05-07-2012
DOI: 10.1007/S00213-012-2787-9
Abstract: Cannabis and alcohol are the most popular drugs amongst recreational users and most prevalent in injured and deceased drivers. The Standardized Field Sobriety Tests (SFST) are commonly used to establish impairment due to drugs and alcohol, but limited empirical evidence exists concerning the combined effects of these drugs on SFST performance. The s le comprised 80 in iduals (31 females 49 males). Age ranged between 21 and 35 years (M = 26.5, SD = 5). Forty participants (15 females 25 males) took part in the low alcohol condition (BAC, 0.05 %). For each part of the study, two levels of ∆9-tetrahydrocannabinol (THC) were administered (1.8 and 3 % THC) or a matching placebo cigarette (0 % THC) in combination with alcohol. Performance on the SFST was assessed 30 min post-dosing. A number of significant differences in SFST performance were identified with 28 % of the s le failing the test (when the head movement and jerks sign was included) when low alcohol and low THC were administered together. When a higher dose of alcohol was administered with a low dose of THC, 38 % of the s le failed the test, and 35 % also failed when the high dose of alcohol was combined with a higher dose of THC. The current results highlight the limited ability of the SFST to identify drug consumption in the absence of any evidence of driving impairment or physiological indicators.
The effects of cannabis and alcohol on simulated driving: Influences of dose and experience
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.AAP.2012.07.016
Abstract: Cannabis and alcohol are the most popular drugs amongst recreational users, and most prevalent in injured and deceased drivers. Clarification of the interactive effects of these drugs upon driving behaviour is critical for reducing drug-related road deaths. The current study had two objectives, to examine the effects of cannabis and alcohol on driving performance, and identify if any differences between the effects of cannabis and alcohol on driving performance exist between regular cannabis users and non-regular cannabis users. The project involved 80 participants (49 male, 31 female) who were abstinent recreational users of alcohol and marijuana. They participated in six experimental sessions that involved the consumption of cannabis cigarettes containing no THC, 1.8% THC or 3% THC together with the consumption of alcohol to obtain either 0% BAC, 0.03% BAC or 0.05% BAC. The six sessions were double-blind, counter-balanced, placebo-controlled and medically supervised. Forty participants were allocated to the cannabis with low alcohol (0.03% BAC) group, and 40 participants were allocated to the cannabis with high alcohol (0.05% BAC) group. Driving simulator performance was assessed at 20min post-drug administration and blood s les were taken before and after driving. Driving simulator performance was more impaired in the THC and alcohol combined conditions. Consistent with past research, the level of THC detected in blood is higher when THC is consumed with alcohol, than when cannabis is consumed alone, and regular cannabis users returned higher levels of THC in plasma than non-regular users. Generally, regular cannabis users displayed more driving errors than non-regular cannabis users.
Managing attention deficit hyperactivity disorder in adults using illicit psychostimulants: A systematic review
Publisher: SAGE Publications
Date: 22-06-2017
Abstract: Attention deficit hyperactivity disorder and stimulant use disorder commonly co-exist, and appropriate treatments have not been well established. To provide guidance for treatment of co-existing attention deficit hyperactivity disorder and stimulant use disorder. A systematic review of published English articles using MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane, utilising consistent search terms. Randomised controlled trials, comparing any treatment arm with a control group, for participants meeting Diagnostic and Statistical Manual of Mental Disorders or equivalent criteria for both attention deficit hyperactivity disorder and stimulant use disorder. Eight trials were identified for inclusion in this review. Four of eight studies showed improvement in attention deficit hyperactivity disorder outcome measures compared with placebo. Two of six studies that reported substance use outcomes showed improvement in treatment arms compared with placebo. Studies to show effect tended to be those with the highest treatment dosage. Evidence for the efficacy of treatment of patients with comorbid stimulant use disorder and attention deficit hyperactivity disorder is limited. Promising outcomes need replication in further studies utilising higher treatment dosage.
The acute effects of 3,4-methylenedioxymethamphetamine and methamphetamine on driving: A simulator study
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.AAP.2011.08.017
Abstract: Illicit drugs such as MDMA and meth hetamine are commonly abused drugs that have also been observed to be prevalent in drivers injured in road accidents. Their exact effect on driving and driving behavior has yet to be thoroughly investigated. Sixty-one abstinent recreational users of illicit drugs comprised the participant s le, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg meth hetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. At each session driving performance was assessed 3 h and 24 h post drug administration on a computerized driving simulator. At peak concentration overall impairment scores for driving (F(2,118)=9.042, p<0.001) and signaling (F(2,118)=4.060, p=0.020) were significantly different for the daytime simulations. Performance in the MDMA condition was worse than both the meth hetamine (p=0.023) and placebo (p<0.001) conditions and the meth hetamine condition was also observed to be worse in comparison to the placebo (p=0.055). For signaling adherence, poorer signaling adherence occurred in both the meth hetamine (p=0.006) and MDMA (p=0.017) conditions in comparison to placebo in the daytime simulations. The findings of this study have for the first time illustrated how both MDMA and meth hetamine effect driving performance, and provide support for legislation regarding testing for the presence of illicit drugs in impaired or injured drivers as deterrents for driving under the influence of illicit drugs.
Examining the effect of dl-3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine on the standardized field sobriety tests
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.FORSCIINT.2012.02.025
Abstract: dl-3,4-methylenedioxymeth hetamine (MDMA) and meth hetamine are commonly used illicit drugs that are thought to impair driving ability. The Standardized Field Sobriety Tests (SFSTs) are utilized widely to detect impairment associated with drugs other than alcohol in drivers, although limited evidence concerning MDMA and meth hetamine consumption on SFST performance exists. The aim of this study was to evaluate whether the SFSTs were a sensitive measure for identifying the presence of the specific isomer d-meth hetamine and MDMA. In a double-blind, within-subject, counter-balanced and placebo-controlled study, 58 healthy and abstinent recreational drugs users were administered three treatments: 100mg of MDMA, 0.42 mg/kg d-meth hetamine, and placebo. For each condition the SFSTs were administered at 4 and 25 h post treatment. d-meth hetamine was not found to significantly impair SFST performance unlike MDMA, which significantly impaired SFST performance in comparison to placebo with 22% of the s le failing the test at the 4h testing time-point. No differences were observed at the 25 h testing time-point for any of the conditions. It was concluded that the SFSTs are not efficient in identifying the presence of low level d-meth hetamine, and are significantly better at detecting the presence of MDMA at the levels assessed.
Factors associated with patient experiences of the burden of using medicines and health-related quality of life: A cross-sectional study
Publisher: Public Library of Science (PLoS)
Date: 28-04-2022
DOI: 10.1371/JOURNAL.PONE.0267593
Abstract: Polypharmacy, defined as the concurrent use of multiple medications, is a growing concern globally. This study aimed to identify the significant factors that predict the perceived burden of medication and health-related quality of life. Adults, aged 18 years and above who have used at least two regular medicines, were invited to complete the study questionnaires between June and October 2019. Multiple linear regression analysis was conducted to identify significant predictors for perceived burden of medication and health-related quality of life. A total of 119 participants completed this study. The average age of the participants was 63 years (SD±16 years). Factors significantly predicting perceived burden of medication were participants’ current health condition (p = 0.001), overall burden of treatment (p .001) and being hypertensive (p = 0.037). Similarly, participants’ current health condition (p .001) and overall burden of treatment (p = 0.086) were significant predictors for perceived health-related quality of life. This study revealed that hypertensive participants in poor health tended to experience higher perceived burden of medication, which in turn was found to be correlated with lower perceived health-related quality of life.
Investigating the Effects of a Multinutrient Supplement on Cognition, Mood and Biochemical Markers in Middle-Aged Adults with ‘Optimal’ and ‘Sub-Optimal’ Diets: A Randomized Double Blind Placebo Controlled Trial
Publisher: MDPI AG
Date: 29-11-2022
DOI: 10.3390/NU14235079
Abstract: Background: Previous randomized controlled trials examining cognitive and mood effects of combination multivitamin supplements in healthy, non-clinical adults have reported mixed results. One purported explanation for this is that the dietary status of participants at the start of supplement interventions may influence the magnitude of the effect of supplementation. Methods: In this study, we evaluated the effect of a multinutrient formula containing B group vitamins, Bacopa monniera and Ginkgo biloba on memory, attention, mood and biochemical markers of nutrient status in middle-aged adults (M = 52.84 years, n = 141) with ‘optimal’ and ‘sub-optimal’ diets over 12 weeks. We hypothesised that active supplementation would differentially improve memory and attention in those with a ‘sub-optimal’ diet. Results: Mixed model, repeated measures analysis revealed that, in comparison to placebo, active treatment was associated with significant increases in B vitamin status (B1, B6, B12). Regarding behavioural outcomes there was no significant benefit to memory (F(1, 113.51) = 0.53, p = 0.470) nor attention (F(1,113.77) = 1.89, p = 0.171) in the whole cohort. Contrary to our hypothesis, there was a significant beneficial effect of supplementation on attentional performance in in iduals with an ‘optimal’ diet prior to supplementation (F(1,57.25) = 4.94, p = 0.030). In the absence of a main effect of supplementation across the entire cohort, there were also a number of significant three-way interactions (treatment by time by diet group) detected in secondary outcomes including lower state anxiety and mental fatigue in those with an ‘optimal’ diet. Conclusion: These findings suggest that the cognitive benefit of B vitamin and herbal supplementation may be dependent on diet quality, supporting the concepts of ‘co-nutrient optimisation’ and interdependency of nutrients. This warrants further investigation. This study advocates characterising the diet of participants prior to supplementation as it may influence the effect of a nutraceutical intervention.
An Australian Residential Youth Training Centre: Population Study
Publisher: SAGE Publications
Date: 03-1976
Uniform orthographies and phonetics in Central Australia 1890–1910
Publisher: Informa UK Limited
Date: 02-09-2018
Related Organisations
Northern Territory Department Of Education And Training Alice Springs Region
Location: Australia
Royal Australian College Of General Practitioners
Location: No location found
The University Of Melbourne Department Of Psychiatry
Location: Australia
Royal Australian College Of General Practitioners
Location: Australia
Related Funding Activities
Roadside Saliva Based Testing For Amphetamine-type Stimulants In Drivers: An Evaluation Of The Relationship Between Positive Drug Tests And Driving Impairment After The Consumption Of Methamphetamine And MDMA
Start Date: 2007
End Date: 2009
Funder: Australian Research Council
View Funded Activity