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Alcohol in country towns; internet treatment for cannabis; substance use in pregnancy and heroin use among ageing Australians: rich agenda for the NDARC Annual Symposium 2011

image - 2011 Symposium Stage Shot
Date Published:
30 Aug 2011
Contact person:
Marion Downey
02 9385 0180

The National Drug and Alcohol Research Centre’s Annual Symposium 2011 will focus on one of the biggest challenges facing the alcohol and other drug sector: integrating research evidence into public policy and clinical practice.

“This has been a recurring theme of our Symposium over the past few years,” says NDARC Director Professor Michael Farrell. “While the research and the findings may change, the onus on the research community to ensure those findings are integrated into public policy and clinical practice remains the same.”

Senior NDARC researchers will present their findings tomorrow at the University of NSW (Tuesday August 30 2011) in an exciting and issue rich program which focuses on some of the most complex and hard to treat cases as well as tackling community and family based challenges around alcohol consumption in Australia.

What: NDARC Annual Symposium 2011
When: August 30 2011
Where: John Niland Scientia building, University of New South Wales, Randwick Campus
Time: 9:00am - 5:00pm

Media are invited to attend sessions or interview presenters during the breaks (10:30am to 11:00am; 12:45 pm to 1:45pm and 3:20 to3:40pm). To arrange interviews contact: Marion Downey on m.downey@usnw.edu.au mobile: 0401 713 850 or Erin O’Loughlin on erin.oloughlin@unsw.edu.au; mobile: 0402 870 996.

For the full program and list of posters please see the attachment below.

Selected highlights (in order of presentation):

Dr Delyse Hutchinson: Parental Substance use during pregnancy: assessing maternal characteristics and infant outcomes.
Dr Hutchinson is leading a major NHMRC-funded Australian trial, involving 2,000 families, which will assess the effects of substance use among pregnant women and their partners on infant development and family functioning. Alcohol and other drug use in pregnancy is a significant public health issue affecting over 100,000 babies in Australia each year. Research shows that substance use at this critical time can have adverse impacts on birth outcomes and later child development, but the effects of such exposures are far from well understood. This is the first large study anywhere in the world to include a detailed assessment of partners’ substance use during the antenatal period. This presentation will present findings from the pilot phase of the project, involving 41 women attending a teaching hospital’s specialist antenatal clinic for women with substance dependence and a comparison group attending a general antenatal clinic. Those attending the specialist clinic had a profile of severe disadvantage and poor health. Nearly 80 per cent of the substance dependent women had smoked tobacco in the previous month compared with just over four per cent of the comparison group. Of concern is the finding that just under half of the comparison group (non-substance dependent) had drunk alcohol in the previous month – more than double the rate of alcohol consumption in the substance dependent group.

Dr Stephanie Taplin: The child protection system and mothers in substance abuse treatment.
Overseas research has found that families where alcohol or other drug use is present are more likely to come to the attention of child protection services, more likely to be re-reported, more likely to have their children removed from their parents’ care, and more likely to have them remain in out-of-home care for long periods of time. Little research has focused on the reasons for this, however, and the appropriateness of the interventions provided to these families. The child protection and mothers in substance abuse treatment study is the first study to interview a large sample of women in opioid pharmacological treatment in NSW about these issues. Some of the major results from this important study will be provided in this presentation. Of the 170 women in the study (all of whom were in treatment) one third of their children were in out of home care (including with relatives) and half of the children aged three to four were in care. Two thirds of the women had been the subject of a child protection report for at least one of their children.

Dr Timothy Slade: Clinical and public health significance of the proposed changes to the diagnosis of alcohol abuse in DSM-5.
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is currently under revision, with the fifth edition (DSM-5) due for release in May 2013. Proposed diagnostic criteria for alcohol use disorders in DSM-5 were recently released and these include a new “craving” criterion and change the threshold for diagnosis. An NDARC study of the new criteria for alcohol use disorders (AUD) has found that the prevalence in the Australian population would increase by 61.7 per cent. Under the new criteria nearly one in 10 Australians would – an additional 592,000. Dr Slade will look at the new criteria and focus on the public health implications of the findings.

Dr Courtney Breen: One size does not fit all. Alcohol use and harms across rural towns in NSW.
Dr Breen is one of the researchers on the Alcohol Action in Rural Communities project (AARC) which has studied 20 towns in rural NSW since 2005. Of these, 10 were selected for active interventions: Corowa, Leeton, Tumut, Forbes, Parkes, Inverell, Gunnedah, Kempsey, Griffith and Grafton. They were matched with their controls on proportion of indigenous people and proportion of young people. Dr Courtney Breen will present findings on the variations of alcohol related violence across towns. These differences are closely related to the individual and total wealth of the towns, with alcohol related violence increasing as wealth of towns increases. The results add to the evidence that increasing the cost of alcohol is one of the most cost- effective ways of reducing alcohol related harms.

Bianca Calabria: A family based approach to reducing alcohol related harms among Aboriginal Australians in rural New South Wales.
Aboriginal Australians experience a disproportionately high burden of alcohol-related harm, relative to the general population. Family relationships are fundamental to the wellbeing and cohesion of Indigenous communities and therefore show great potential for reducing alcohol-related harms. This study aims to develop and evaluate a culturally appropriate family-based approach to reduce alcohol-related harms among Aboriginal Australians in rural New South Wales. Survey results capturing the acceptability of the proposed family-based approach to clients of an Aboriginal Community Controlled Health Service and a drug and alcohol treatment agency will be presented.

Associate Professor Anthony Shakeshaft: The Alcohol Action in rural Communities Project. Overall findings and implications for future community based drug and alcohol research.
The Alcohol Action in Rural Communities (AARC) project is the most methodologically rigorous evaluation of community action aimed at reducing alcohol-related harm ever under-taken internationally. A total of 13 interventions were devised and agreed between communities and the research team, implemented and costed over a five-year period (2005-2009). A critical implication of AARC has been to increase recognition of the importance of greater integration between practice, policy and evaluation. As a clear example of greater integration between clinical practice and evaluation, a practical hospital Emergency Department (ED) intervention, nested within AARC, was designed in close consultation between researchers and ED staff. It achieved a statistically significant reduction in the quantity/frequency of consumption for patients with an alcohol-involved ED presentation, relative to screening alone, at a cost of $5.83 per patient or 48 cents for each unit reduction in average weekly consumption.

Dr Sally Rooke: Reduce your use: Promising findings from Australia’s first internet-based cannabis treatment study.
Dr Sally Rooke, from the National Cannabis Prevention Information centre (NCPIC), will present the results of the first Australian study of its kind, investigating whether the online-delivered cognitive behavioural therapy program is effective in reducing such things as frequency of cannabis use. Initial results suggest that Reduce Your Use may be an effective treatment for individuals seeking to quit or reduce their cannabis use. Six-weeks post-intervention data are currently available for 130 participants, while 3-month follow-up data are available for 91 participants. While data collection is still underway, follow-up data shows significantly larger reductions in cannabis dependence symptoms (measured using the Severity of Dependence Scale) in the intervention group relative to the control group, with a mean change score difference of 2.48, p = .04. Additionally, past-month abstinence is higher in the experimental group compared to the control group (22.9% versus 13.3% of available cases). Reductions in past-month cannabis use are greater in the experimental group by 2.84 days.

Dr Rebecca McKetin: Methamphetamine Psychosis and its response to drug treatment
Methamphetamine use can induce a transient paranoid psychosis. However, it is widely recognised that not all methamphetamine users will experience psychotic symptoms from the drug. This talk will explore the level of risk associated with different patterns of methamphetamine use, and it will present longitudinal data examining the individual variability in vulnerability to methamphetamine psychosis. Finally, it will demonstrate how treating methamphetamine dependence can substantially reduce the risk of psychotic symptoms in this population.

Professor Kate Dolan: Randomly allocating prisoners to methadone: where are they ten years later?
Methadone Maintenance Treatment (MMT) had been studied ten times in NSW prisons but the results were not convincing. After two years of ethical debates, a randomised controlled trial started in 1997. This presentation reports on results from 375 prisoners studied over 10 years. Treated inmates were more likely to be in the community than their untreated peers. Twenty eight (7.5 per cent) of study participants died over the ten year period and half of the deaths were due to drugs. The risk of death of members of this group decreased when in prison or in methadone treatment. Within two years 84 per cent of heroin dependent ex-prisoners were back in prison compared to the state average for all prisoners of 45 per cent. Over the ten year period 99.5 per cent of the group being followed went back to prison on average of 5 times and for an average of three months at a time or three and half years in total. Just being on methadone when released did not reduce the chance of going back to prison but if this treatment was continued into the community then the rate of re-incarceration was reduced by 20 per cent.

Professor Shane Darke. The Ageing heroin user – policy and clinical implications. Is Australia prepared?
It is misguided to see heroin use as a transitory phase that young drug users will mature out of. The number of illicit drug users aged over 50 (in the US) and 65 ( in Europe) who will require treatment is expected to double between 2001 and 2020, The indicators we have in Australia, such as age of people accessing treatment, point to the fact that we are also seeing similar patterns of ageing among heroin users. The proportion of new injectors in Australia (three years or less) has dropped to a low of five per cent in 2010 from a high of nearly 20 per cent in the 1990s. Over a third of the users in NDARC Drug Trends surveys are now over 40 and we have seen the average age of clients of needle syringe programs increase from 27 to 37 over the 10 years to 2010.
Professor Darke’s new book, The Life of the Heroin User: Typical Beginnings, Trajectories and Outcomes, published by Cambridge University Press, will be launched by Professor Geoff Gallop immediately after the Symposium. This important new work is the first book to apply a biographical approach to the lifecycle of the heroin user from birth until death.
Chapters address each stage of the user's life, including childhood, routes to use, the development of dependence, problems arising from addiction, death, and options for treatment and prevention.