Reducing Alcohol-related Harm In Rural Communities
Funder
National Health and Medical Research Council
Funding Amount
$265,000.00
Summary
In 1992 in Australia, there were an estimated 3,660 alcohol-related deaths and 71,593 alcohol-related hospital episodes, resulting in a total economic cost of $4,031.9 million, 84% of which was avoidable. In 1998, about half of all males and a third of all females drank at least once a month at levels that placed them at risk of harm. In NSW, alcohol was estimated as being a causal factor in about one-quarter of all road traffic deaths in 1995 and was associated with a 58% increase in hospital u ....In 1992 in Australia, there were an estimated 3,660 alcohol-related deaths and 71,593 alcohol-related hospital episodes, resulting in a total economic cost of $4,031.9 million, 84% of which was avoidable. In 1998, about half of all males and a third of all females drank at least once a month at levels that placed them at risk of harm. In NSW, alcohol was estimated as being a causal factor in about one-quarter of all road traffic deaths in 1995 and was associated with a 58% increase in hospital utilistion rates between 1988-89 and 1990-91. The burden of suffering appears disproportionately higher in rural areas of NSW: per capita rate of convictions associated with a prescribed alcohol concentration in rural towns was approximately double that in metropolitan areas in 2000. The rate of attendances at hospital accident and emergency departments was also higher in rural areas. These data suggest a need for additional effort to reduce alcohol-related harm in rural, relative to metropolitan, areas. In Australia, there have been no well-controlled, community-based, attempts to reduce alcohol-related harm by simultaneously implementing a range of interventions. The conduct of a large-scale randomised controlled trial (RCT) to investigate the effectiveness of this approach is difficult to justify, due to the substantial costs associated with such a rigorous design. However, a less rigorus, though equally valid, design, such as a stepped wedged approach, would likely provide good evidence to justify the subsequent conduct of an RCT. If the expected outcomes are not achieved, the conduct of an RCT can be postponed until reasonable preliminary evidence regarding the types of community-based interventions most likely to be effective is obtained. In either case, this study will provide valuable information as to which community-based interventions, and in what combination, are most likely to reduce the occurrence of alcohol-related harm in rural communities in Australia.Read moreRead less
Fine Mapping Of The ADH Region For Alcohol Metabolism, Use And Dependence
Funder
National Health and Medical Research Council
Funding Amount
$215,690.00
Summary
It is widely known that alcohol use and alcohol dependence can cause many social problems and morbidity. We know that social and and cultural factors can affect the possibility of becoming alcohol dependent. We also know that inheritance plays a major role in the risk of becoming dependent upon alcohol. Two inherited causes or genes have already been identified as causing some people to avoid alcohol and so have less chance of becoming dependent upon it. Clues as to why this happens come from wh ....It is widely known that alcohol use and alcohol dependence can cause many social problems and morbidity. We know that social and and cultural factors can affect the possibility of becoming alcohol dependent. We also know that inheritance plays a major role in the risk of becoming dependent upon alcohol. Two inherited causes or genes have already been identified as causing some people to avoid alcohol and so have less chance of becoming dependent upon it. Clues as to why this happens come from what happens to alcohol following a drink. The body detoxifies itself of alcohol in the liver. There it is converted to very highly toxic acetaldehyde and this is normally rapidly removed by a protein called aldehyde dehydrogenase. Some people do not have a normally functioning form of this protein and cannot remove the acetaldehyde from their bodies. They suffer unpleasant side effects such as nausea, facial flushing and sickness. Consequently they learn by experience to avoid alcohol use and are less likely to develop dependence. We now know that even people with a normally inherited form of aldehyde dehydrogenase can have a lowered risk of dependence. The rate at which our livers convert alcohol to actetaldehyde is also a key factor. Those who are inherently quick at this process again learn to avoid alcohol, others are more at risk. The hypothesis will be tested with a unique set of twins who have provided us with detailed information on how quickly they detoxify alcohol and of their drinking habits for over 20 years. Collectively they will enable us to determine if there is a major genetic influence on alcohol use and dependence that is caused by inter-individual differences in a gene for alcohol metabolism. The DNA of these twins will be used to locate mutations that we predict have a common effect upon our measures of alcohol detoxification, drinking habits and risk of alcoholism.Read moreRead less
Single-focussed Versus Integrated Cognitive Behaviour Therapy For Co-occurring Depression And Alcohol Use Problems
Funder
National Health and Medical Research Council
Funding Amount
$777,500.00
Summary
This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our c ....This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our community, it is still not clear how best to manage and treat this group of people. Typically, people will often receive treatment for one part of their presentation, for example their depression or alcohol use problem. However, it is uncommon for the two conditions to be treated in an integrated way. This is certainly true for psychological treatments. Research programs to date have explored effective treatments for depression and alcohol use in the absence of the co-occurring condition. Currently it is not known how well people with co-occurring alcohol use problems and depression respond to treatments with a singular focus. Furthermore, it is not known whether integrating both alcohol use and depressive treatment approaches provides any additional benefit. This study is therefore significant, as it is one of the first to explore effective treatment approaches among people with co-occurring depressive and alcohol use problems. Resolution of these issues will better inform the treatment choices of clinicians practicing in both mental health and alcohol-other drug settings. Importantly, this will potentially improve the match between treatment and people with depression and substance use problems, a clinically prevalent population encountered in community settings.Read moreRead less
The Effects Of Mixing Alcohol And Prescription Drugs On Driving And Cognitive Performance: A Randomised Simulator Study.
Funder
National Health and Medical Research Council
Funding Amount
$495,226.00
Summary
A large proportion of traffic accidents are linked to alcohol and prescription drug use. There is poor understanding of these drugs on driving performance, both alone and in combination with alcohol. This study examines the effects of commonly used prescription medications (diazepam and codeine) and alcohol, in combination, on driving-related skills and cognitive performance in healthy volunteers. The results of this study will inform future policy, and clinical and public health strategies.
A New Approach To Curbing Risky Trajectories Of Adolescent Alcohol-tobacco Use: A Tailored Brief Program For Parents.
Funder
National Health and Medical Research Council
Funding Amount
$320,271.00
Summary
Parent-adolescent interactions predict adolescent involvement in alcohol and tobacco use, and parent-oriented programs reduce conduct problems. Nevertheless, parent training is a rare alcohol-tobacco-related prevention strategy. This research will evaluate a brief parent program for adolescents at risk of escalating alcohol-tobacco problems. The technology should be cost-effective and readily complement existing school prevention strategies.
Randomised Controlled Trial Of A New Intervention For Alcohol Craving
Funder
National Health and Medical Research Council
Funding Amount
$780,673.00
Summary
Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and lo ....Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and long-term maintenance of change. Whilst current medications target craving, they provide only short-term symptom relief, and not all people find them effective. Cravings are both distracting and distressing during treatment, and increased craving often predicts treatment drop-out and relapse. This project evaluates a new treatment for alcohol misuse: CARM - Craving for Alcohol: Reduction and Management. This 8-session enhanced Cognitive-Behaviour Treatment (CBT) focuses on teaching people new skills to manage and reduce cravings, and is based on a new theory of craving that has strong research support. The study compares 4 groups: CARM; a more traditional CBT treatment for alcohol problems [motivational interviewing, problem solving for high-risk situations, and relapse prevention]; plus two brief interventions [Motivational Interviewing plus Self-Monitoring, and Self-Monitoring alone] both followed by CARM after an 8 week delay. All participants are able to set their own goals of abstinence or reduced use. Expected outcomes: all participants will learn effective skills to manage their alcohol use, resulting in significant reductions in alcohol consumption and fewer problems from alcohol use; however, those receiving CARM will find it easier to manage cravings during treatment, and will make faster progress and show less treatment drop-out. It is also anticipated that participants in CARM will show better long-term maintenance of treatment gains.Read moreRead less
Alcohol, Angry Rumination, And Aggression: The Role Of Acute Impairment Of Executive Functioning
Funder
National Health and Medical Research Council
Funding Amount
$341,780.00
Summary
In Australia, alcohol-induced aggression imposes substantial psychological, public health, social, and economic burdens on victims, perpetrators, and society. When people drink and brood over interpersonal transgresssions, they are at increased risk of violence, even toward the innocent. The goal of the proposed research is to identify neuropsychological mechanisms that account for this increased aggression.
Mental Disorders And The Social Transitions Of Adulthood: A 20-year Follow-up Of The Victorian Adolescent Health Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$441,224.00
Summary
This study aims to understand how transitions to parenthood, marriage and employment might be affected by the experience of a mental disorder or problems with alcohol or other drugs. It will also look at a question of whether making a good transition (e.g. a satisfying marriage) can help recovery from a mental or substance use disorder.