ADRIA Projects

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Exploring how LGBTQ communities experience, conceptualise and respond to drug-related harm

Lead organisation: Thorne Harbour Health
Project partner(s): Australian Research Centre in Sex, Health & Society (LaTrobe)
Project lead: Carolyn Gillespie and Adam Bourne
Funding amount: $260,764.00
Duration: 24 months

Description:
Research into drug harms experienced by LGBTQ communities is extensive and well-established. These communities experience elevated levels of drug use compared to heterosexual and/or cis-gendered counterparts. Research has shown that elevated drug use in these communities is contextualised by unique stressors including those related to social marginalisation as well as a means of facilitating connections to and within queer communities.
However, considerably less research has examined how AOD use among LGBTQ people impacts the physical, mental or social wellbeing. Using multiple sources of qualitative data, this project will examine the impacts of AOD use among members LGBTQ communities and how they experience, conceptualise and respond to drug use and related harms, as well as what concerns influence their engagement with alcohol and other drug services.

Enhancing collaboration between an AOD service and primary care to improve treatment of benzodiazepine dependence: Evaluating a consumer-led approach to de-prescribing

Lead organisation: Reconnexion (EACH)
Project partner(s): Deakin University
Project lead: Janet Shaw and Elizabeth Manias
Funding amount: $59,157.00
Duration: 24 months

Description:
Benzodiazepines and z-drugs (BZRAs) are sedative-hypnotic medications commonly used to manage insomnia and anxiety. Effective in the short term, use of these medications are not recommended for longer than four weeks due to the risk of dependence. Despite this, BZRA-dependence remains under-identified and under-treated. In Victoria, BZRAs have been the leading contributor to overdose deaths for over ten years.
This research seeks to establish stronger collaborative pathways between state-wide specialist services and primary care to reduce harms associated with BZRA dependence. The primary aim is to examine the effectiveness of a consumer-led de-prescribing tool to support GPs in identifying and responding to BZRA dependence.

Managing substance use disorder (SUD) in the presence of attention deficit hyperactive disorder (ADHD): Does active management of ADHD improve outcomes?

Lead organisation: Goulburn Valley Alcohol and Drugs Service (GVADS)
Project partner(s): Swinburne University
Project lead: Cheryl Sobczyk and Ed Ogden
Funding amount: $293,249.00
Duration: 24 months

Description:
Attention Deficit Hyperactive Disorder (ADHD) is a common neurodevelopmental disorder defined by the persistence of dysregulated attention, activity and impulsivity. People with ADHD are more prone to accidents and injuries, have a higher mortality rate and is characterised by underperformance in education and work. They are also more likely to be involved in crime and develop a substance use disorder. Despite this, ADHD is under-recognised and under-treated in Australia, and many psychiatrists will not treat someone for ADHD if they have current or historical substance use disorder (SUD).
The purpose of this project is to provide an integrated specialised clinic for clients with comorbid ADHD and SUD. Clients attending the clinic will have access to specialised assessment, psychoeducation, medication and ADHD coaching. The primary aim is to determine whether access to the specialised clinic improves treatment outcomes for clients with comorbid ADHD and SUD, as well as to examine the effectiveness and utility of the integrated team approach.

 

Enhancing pharmacist involvement in care (EPIC) MATOD implementation study

Lead organisation: Peninsula Health
Project partner(s): Monash Addiction Research Centre
Project lead: Kirsty Morgan and Suzanne Nielsen
Funding amount: $440,542.00
Duration: 30 months

Description:
Medication assisted treatment for opioid dependence (MATOD) is a clinically- and cost-effective treatment for opioid dependence. Despite this, demand for MATOD in Australia significantly exceeds capacity. One driver of this capacity shortage is a lack of clinical practitioners prescribing MATOD, occurring for a range of reasons.

‘Collaborative’ or ‘shared-care’ models—where responsibility and tasks are shared across multiple healthcare professionals—have shown to be successful in the management of a range of chronic conditions (including obstructive pulmonary disease and diabetes). This research will develop and trial a shared care model of MATOD provision involving both prescribers and pharmacists. To date, a prescriber-pharmacist shared-care model for MATOD is yet to be trialed in Australia.

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Evaluating an online relationship program to enhance outcomes for people in alcohol and other drug treatment

Lead organisation: Odyssey House
Project partner(s): Deakin University
Project lead: Stefan Gruenert
Funding amount: $147,250.00
Duration: 24 months

Description:
Research consistently demonstrates that strain and conflict in people’s intimate relationships can be exacerbated among those engaging in problematic substance use. Further, a large proportion of problematic substance use is motivated by efforts to regulate distress associated with insecure and conflicted relationships, including trauma associated with relationship aggression and violence. Decades of research has also shown that relationship therapy can improve the quality of relationships and general wellbeing. Despite this, relationship therapy is often expensive and hard to access, especially for people who are socio-economically disadvantaged, live in rural areas, or marginalised.

This research will trial the OurRelationships program—a relationship-focused therapeutic program developed in the US supported by a strong evidence base—with clients in residential AOD treatment settings. The trial will measure (i) whether the OR program improve participants’ relationship outcomes and (ii) whether participation in the program resulted in improvements to mental health, quality of life and a reduction in relapse and/or AOD use.

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A randomised controlled trial of a cognitive “brain-training” smartphone app to help reduce alcohol use during alcohol treatment

Lead organisation: Turning Point (Eastern Health)
Project partner(s): St Vincent’s Hospital, Melbourne; Uniting Vic-Tas Alcohol and Other Drug Services; Star Health; Monash Health; Odyssey House.
Project lead: Victoria Manning
Funding amount: $137,539.00
Duration: 24 months

Description:
Almost half (45%) of those presenting for AOD (Alcohol and Other Drug) treatment have alcohol as a drug of concern. Whilst common psychological treatments focus on strengthening the conscious cognitive processes of those receiving treatment for alcohol use, they do not address the subconscious “auto-pilot” response to alcohol cues that drive impulses to drink. Approach-avoidance training (AAT) involves strengthening sub-conscious responses to cues through practise—responding to alcohol and non-alcohol images displayed on a computer screen. Multiple trials have shown AAT reduces the likelihood of relapse following residential treatment.

This research will trial providing AAT training via a smartphone app, making the training a highly scalable and easily accessible tool to reduce alcohol craving and consumption when it is most needed. A recent pilot study of our “AAT-App” demonstrated good feasibility, acceptability and significant reductions in alcohol consumption, craving and related outcomes. To confirm these initial results, this research will conduct a double-blind randomised controlled trial comparing the AAT app against a control appin 300 clients attending alcohol treatment across six Victorian AOD services.

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Can extended release guanfacine improve outcomes in young people seeking treatment for problematic cannabis use?

Lead organisation: Youth Support + Advocacy Service
Project partner(s): Orygen Mental Health
Project lead: Gill Bedi and Andrew Bruun
Funding amount: $574,578.00
Duration: 48 months

Description:
Cannabis is the most used illicit drug in Australia and globally, with use linked to various harms to users’ mental health and respiratory system. Young people and adolescents are at particular risk of the harms associated with problematic cannabis use due to impacts on their cognitive development. Currently, 61% of young Australians who present for drug treatment identify cannabis as their primary drug of concern. Yet, to date there are no efficacious pharmacotherapies for cannabis-related problems, which limits treatment options.

The research will trial extended-release guanfacine—currently used to treat childhood and adolescent ADHD—as a pharmacotherapy for problematic cannabis use among young people seeking treatment for problematic cannabis use. We hypothesise the treatment may (a) reduce withdrawals experienced when cannabis use is ceased and (b) increasing cognitive processes related to inhibition thereby enhancing participants’ ability to complete treatment. The research will be conducted in youth residential withdrawal services.

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