This issue of CentreLines showcases some of NDARC’s current and recently completed internationalresearch and activities. As NDARC continues to expand, currently employing more than 100 staff, theCentre’s international projects are also growing. In Headspace, NDARC Director, Professor RichardMattick, discusses our evolving profile in the international arena. Our commitment to improvingtreatment and other intervention responses to alcohol and drug-related harm is well demonstratedthrough our global work. A critical aspect of this work involves building the capacity and willingness of countries to invest in treatment and interventions that have proven to be effective in reducing harm.

Project notes covers a broad range of studies including: community based treatment for youth;development of treatment guidelines for drug dependence, including treatment in closed settings;HIV among injecting drug users; smoking control; the global burden of disease; drug tourism; and,the socio-economic impact of drugs and crime. These research projects span several countriesincluding China, Lao PDR, Thailand, Vietnam, Burma, Malaysia, Singapore, Mongolia and Iran.

Over the past year, a number of us have been busy travelling to many parts of the world not only toconduct research and attend meetings, but also to build and strengthen partnerships with variousacademic institutions, government and non-government organisations, particularly in the Asia-PacificRegion. In recent years, NDARC has developed strong linkages with the World Health Organization(WHO), the United Nations Office of Drugs and Crime (UNODC) and the Joint United NationsProgramme on HIV/AIDS (UNAIDS) through several projects and activities. This issue of CentreLinesprovides examples of these valuable collaborations.

If you would like to learn more about NDARC’s international research and related activities pleasefeel free to contact me: a.cohen@unsw.edu.au or visit our website: http://ndarc.med.unsw.edu.au

Anjalee Cohen Research Fellow and International Research Coordinator

A bi-monthly newsletter from the National Centres for Drug and Alcohol ResearchPublished this issue by the National Drug and Alcohol Research Centre, Sydney

. . . . . . . . . . . . . . . . . . . . .1Anjalee Cohen introduces this edition ofCentreLines with a focus on internationalresearch and activities

. . . . . . . . . . . . . . . . .2Richard Mattick discusses NDARC’sexpanding international role in drug andalcohol research, policy and treatment

. . . . . . . . . . . . .3Building capacity for community-basedtreatment of young drug users in theGreater Mekong Subregion Clinical guidelines for the management of drug dependence in South-East AsiaDevelopment and evaluation of a clinicfor female drug users in Iran Evaluating the cost-effectiveness ofSingapore’s National Smoking ControlProgram Global Burden of Disease: MentalDisorders and Illicit Drug Use Expert Group Guidelines for psychosocially assistedpharmacotherapy of opioid dependenceThe harms associated with drug tourismin northern Thailand HIV incidence among IDUs in northernShan States, Burma Measuring the socio-economic impact ofdrugs, crime and corruption in Lao PDRRapid assessment and response to drug use and HIV in Mongolia

. . . . . . . . . . . . . . . . . . .6Summaries of recently published articles

. . . . .7

. .8recent publications

upcoming events

abstracts

project notes

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edspace

contents

NDARC (24)

November 2008

Funded by the National Drug Strategy

Registered by Australia Post – Print Post Publication No

PP236697/00013ISSN 1034-7259

CentreLines is a joint publication from theNational Drug and Alcohol Research Centre,Sydney and the National Drug ResearchInstitute, Perth. It is published bi-monthlyand produced alternately by each Centre.

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A recent review by a team at NDARC working as the Secretariat of the Reference Groupto the United Nations on HIV and Injecting Drug Use found that injecting is now verymuch a global phenomenon. However, the data currently available are poor. Injectinghas been reported in countries shaded on this map – darker shading is used forcountries with available prevalence data; lighter shading indicates unknown prevalence.

headspaceThe international arena: NDARC’s role in global research

The internationalarena: NDARC’srole in globalresearchRichard P. Mattick Director, NDARC

NDARC has always had some involvement ininternationally focused work on alcohol and illicit drugs research. This has been formallyrecognised through its Collaborating Centrestatus with the World Health Organization(WHO), and historically was embodied throughNDARC researchers’ involvement with crucialinternational research and scientific documentsevaluating issues such as the health andpsychological effects of cannabis use, evidenceon the effectiveness of treatments for opioiddependence, and input at a number of levels in international drug policy debates.

In recent years, the breadth of international work that NDARC staff has been involved in has grown. In 2003, seed funding for theProgram of International Research and Trainingwas provided by the Australian GovernmentDepartment of Health and Ageing (seehttp://ndarc.med.unsw.edu.au/NDARCWeb.nsf/page/PIRT for more information). Over thefollowing years, training was provided both inAustralia and in other countries to thoseinterested in learning about alcohol and otherdrugs, and in learning about research methods.

Over the past couple of years that profile hasexpanded. It has moved from small scalework, such as rapid assessments and smallpieces of work for NGOs and UN agencies, to larger projects involving many collaboratingresearchers both within NDARC and outsidethe Centre. There are an increasing number ofresearchers involved in this work, which spansa wider number of domains and geographicalareas (for more information seehttp://ndarc.med.unsw.edu.au/NDARCWeb.nsf/page/International+Profile). In this issue ofCentrelines, we summarise some of thecurrent international work that NDARCresearchers are involved in. As you will beable to see, this work ranges from conductingrapid assessments of drug use in low andmiddle income countries, to multi-country trials of treatment implementation for drugdependence.

Our engagement in the international arena is notconfined to traditional research work. In 2006,we were involved in submissions to WHO’sModel List of Medicines, which were successfulin ensuring that methadone and buprenorphinebe listed as part of any country’s “essential”medicines, given the evidence of effectiveness

we presented in those applications. Since 2006,the Drug Policy Modelling Program has beenbased at NDARC, and involves a consortium of internationally renowned researchersconducting policy relevant research to informnational and international level policymaking(see http://www.dpmp.unsw.edu.au for moreinformation). We are currently leading the workon estimates of the Global Burden of Disease(GBD) attributable to illicit drug dependence aspart of the GBD2005 project that is being run by a consortium of researchers from HarvardUniversity, University of Queensland,Washington University in Seattle, Johns HopkinsUniversity, and WHO (for more information seehttp://www.gbd.unsw.edu.au).

In May 2007, NDARC was awarded thecontract for undertaking the role of theSecretariat for the Reference Group to theUnited Nations on HIV and Injecting DrugUse. The Reference Group is an independentgroup of international experts established toprovide technical advice to the co-sponsors of the United Nations Joint Programme onHIV/AIDS on effective approaches to HIVprevention and care among people who injectdrugs (see http://www.idurefgroup.unsw.edu.au).The first major piece of work of the ReferenceGroup was published in The Lancet thismonth

1. It contains the results of a large

systematic review and critique of the peer-reviewed and non-peer reviewed (“grey”)literature reporting data on the epidemiologyof injecting drug use (IDU) and HIV amongpeople who inject drugs. Country-specificestimates were derived from this literature,and regional and global estimates of thenumber of people who inject drugs, and who may be living with HIV, were made.

IDU was identified in 148 countries1. The

presence of HIV among injectors had beenreported in 120 of these countries. Prevalenceestimates of injecting drug use could beascertained for 61 countries containing 77% ofthe world’s total population aged 15-64 years.The largest numbers of injectors were found inChina, the US and the Russian Federation,where HIV prevalence among injectors wasestimated at 12%, 16% and 37% respectively.HIV prevalence among people who inject drugswas between 20% and 40% in six countries and>40% in another eight countries. Extrapolatedestimates suggested that 15.9 million (range11.0-21.2 million) people might inject drugsworldwide, and that 3 million injectors may beliving with HIV (range 0.8-6.6 million).

The magnitude of the risk has not been met withan equally concerted investment in research toaccurately quantify the problem. It may currentlybe beyond the capacity of some countries.Guidelines for the conduct of good qualityresearch in this area could assist suchcountries, with a focus upon indirect prevalence

estimation and regular sentinel HIV surveillance.Developing research capacity within countries is clearly an important priority

1.

Research on the epidemiology of drug use and harm is one of the core foci of NDARC. The other major focus is upon the examinationof effective interventions to address drugdependence and other harms of drug use. Asnoted above, we were involved in applicationsfor the inclusion of the most effectivepharmacotherapies for opioid dependence onthe List of Model Medicines. NDARC staff havealso been involved in collaborative work withUNAIDS, the United Nations Office on Drugsand Crime (UNODC) and WHO on other work tobetter define and measure how many countriesare providing effective interventions, and toconsider what “targets” countries might have interms of service provision coverage for relevantpopulations. This has included work with WHOand UNODC on their joint target setting guidefor universal access to HIV prevention,treatment and care for IDUs; and with UNAIDSto consider the reporting of member states’ dataon coverage as reported in the UNGASSreporting round in 2008.

People who use drugs have the right to haveaccess to the highest standard of healthattainable. This is in accordance with the 1948United Nations’ General Assembly UniversalDeclaration of Human Rights

2. NDARC has and

will be involved in work to improve the extent to which we are able to respond to harms witheffective interventions to improve quality of lifefor this group, as well as work to improve thecapacity and willingness of countries to invest in those interventions that we already know tobe effective

3. cl

References1. Mathers, B., Degenhardt, L., Phillips, B., Wiessing,

L., Hickman, M., Strathdee, S., et al. Globalepidemiology of injecting drug use and HIVamong people who inject drugs: A systematicreview. The Lancet 2008;372:1733-1745.

2. United Nations. Universal Declaration of HumanRights. UN General Assembly Resolution 217 A(III) of 10 December 1948. New York: UnitedNations, 1948.

3. United Nations. Declaration of Commitment onHIV/AIDS. UN General Assembly Special Sessionon HIV/AIDS. New York: United Nations, 2001.

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project notesBuilding capacity forcommunity-basedtreatment of young drugusers in the GreaterMekong Subregion John Howard and UNESCAP,Bangkok

Most drug ‘treatment’ in the Greater MekongSubregion comprises placement in compulsoryresidential facilities, and separate facilities foryoung people are virtually non-existent. Thisproject aimed to build capacity for effective andcomprehensive community-based treatmentinterventions as an alternative to initial andcontinued placement in adult-oriented facilitiesin four of the six subregion countries – China,Lao PDR, Thailand and Viet Nam.

The strategy largely comprised workforcedevelopment for staff of NGOs and compulsoryresidential facilities, peer educators and keycommunity leaders. The participating partnerswere: China – Yunnan Institute for Drug Use(YIDA) in Kunming; Lao PDR – Vientiane YouthCentre for Health and Development (VYC) of the Lao Women’s Union; Thailand – NonthaburiProvince Juvenile and Family Court andAssociate Judges and Community Network; and Viet Nam – Department of Social EvilsPrevention of the Ministry of Labour, Invalidsand Social Affairs.

Phase I (2002-2004) focused on providing anoverview of alternative drug use prevention,treatment and rehabilitation for young people.Training materials were developed (UNESCAP,2006, Young people and substance use:prevention, treatment and rehabilitation) andprovides an orientation to conceptualisingsubstance use by young people that is holistic,non-punitive and based around case studiesgenerated during field visits.

Phase II (2005-2006) focused on strengtheningthe effectiveness of the treatment of young drugusers, supported by a ‘tool kit’ (UNESCAP,2007, A tool kit for building capacity forcommunity-based treatment and continuingcare of young drug users in the Greater MekongSub region). From field visits, there was a clearneed for a strong focus on basic counsellingand treatment planning, especially relapseprevention. The tool kit introduces case studiesand addresses assessment, treatment planning,individual, group and family counselling, andrelapse prevention planning.

The tool kit also contains four videos for use in training made by the participatingorganisations, which mainly focus on illustratinghow substance use by a young persondevelops and how various members of thecommunity all play a role in relapse prevention.One video features the work of the Juvenile andFamily Court of Nonthaburi Province, Thailand,and demonstrates the roles of the Associate

Judges and the Community Network to divertyoung drug offenders from custody. The videoalso illustrates how they are assessed,supported and treated in the community.

Phase III (2007-2008) focused on field-testingand revising the tool kit, enhancing researchcapacities, encouraging the development ofenabling policy environments, such as thosethat provide for diversion of young drug usersfrom compulsory residential to community-based treatment, and increasing re-integrationsupport available to young people who returnfrom compulsory treatment centres.

Resources available: http://www.unescap.org/esid/hds/resources/publications.asp

Clinical guidelines for themanagement of drugdependence in closedsettings in South-EastAsia: Withdrawalmanagement andtreatment approachesSarah Larney, Kate Dolan andBradley Mathers

The Program of International Research andTraining at NDARC was commissioned by theWorld Health Organization to produce guidelinesfor withdrawal management and treatment ofdrug dependence in closed settings in South-East Asia. ‘Closed settings’ is a term that refersto any institution in which people are detainedagainst their will. It is a deliberately broad termthat refers not only to prisons, but also to ‘boot-camp’ style institutions that are outside theprison system, but which are used to detainpeople who use drugs. These institutions arefound throughout South-East Asia.

A field visit was undertaken to closed settings in China, Vietnam and Malaysia in order tounderstand the context within which theguidelines will be used. This visit yieldedvaluable information regarding the feasibility ofproviding various withdrawal management andtreatment interventions in these centres. The guidelines were drafted throughout 2007and submitted for expert review. Following theexpert review, a field test of the guidelines was

conducted with staff of closed settings in LaoPDR and Cambodia. Staff received two daystraining in the use of the guidelines. Staffknowledge of withdrawal management anddrug treatment improved significantly followingthe training, as assessed using a pre- and post-training knowledge questionnaire.

The field test highlighted a number of issuesaround cultural acceptability that will beaddressed through revision of the guidelinesbefore their publication by the World HealthOrganization in early 2009.

Development andevaluation of a clinic forfemale drug users in IranKate Dolan, Shabnam Salimi,Bijan Nassirimanesh and SetarehMohsenifar

With funding support from the DrososFoundation, we established a Women’s Clinic inTehran with 8 staff and 97 women have visitedin the first year. They were aged 36 years onaverage. Most were unemployed, unskilled anddependent on drugs. The mean age thatwomen first used an illegal drug was 22 years.In two thirds of the cases, relatives or a partnersuggested drug initiation. Two thirds of womenmentioned opium was the first drug they used,followed by heroin. One quarter declared alifetime history of injection. More than half had aregular sexual partner. Just under half had beenimprisoned at some time. The women are beingre-interviewed for any changes in risk behaviourand health status.

Evaluating the cost-effectiveness ofSingapore’s NationalSmoking Control ProgramChris Doran

The adverse effects of tobacco use on healthare well established with decades of researchproviding conclusive evidence of the appallingtoll of premature morbidity and mortalitycaused by tobacco smoking. As the leadingcause of preventable deaths in the world,tobacco smoking currently accounts for one inten adult deaths worldwide. The WHOestimates that some 10 million people will dieeach year by 2025 based on current smokingtrends. Half the people that smoke today –about 650 million people – will eventually bekilled by tobacco.

It is widely recognised that a comprehensivemix of strategies and approaches is necessaryfor tobacco control programs to be effectiveand successful. As early as the 1970s,Singapore had introduced measures to informand educate the public on the harmful effects oftobacco and encouraged them to stop

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smoking. The first anti-smoking laws wereenacted to restrict smoking in certain publicplaces and prohibit tobacco advertisements inthe local media. In 1972, fiscal measures wereused for the first time to discourage people fromsmoking. Cigarette duties were raised in linewith the official policy of discouraging smoking.In the mid 1980s, Singapore’s Ministry of Healthdrew up a comprehensive long term smokingcontrol plan with the aim of reducing smokingprevalence using a multi-pronged approach.Through public education, increased taxation,legislation, community involvement and theestablishment of non-smoking areas andprovision of services for smoking cessation, itwas projected that the smoking rate wouldhalve within ten years and the country wouldconsist mainly of non-smokers.

A National Smoking Control CoordinatingCommittee, spearheaded by the Ministry ofHealth, and made up of representatives fromthe public and private sectors, was set up toformulate policies, coordinate activities andmonitor the anti-smoking programme inSingapore. The National Smoking ControlProgramme (NSCP) was launched in 1986 toreduce smoking rates with the objectives to:prevent initiation of smoking among youths;promote smoking cessation among adults andyouths; and, protect non-smokers byeliminating exposure to passive smoking. TheHealth Promotion Board (HPB) formed in 2001continued to intensify the National SmokingControl Programme.

Smoking prevention and control measures havebeen largely successful over the past twodecades. The country’s overall smokingprevalence has decreased from 20% in 1984 to13% in 2004. Lung cancer incidence rates havedecreased from a high 63 per 100,000population in the early 80s to 45 per 100,000population at the turn of the century for males.Lung cancer rates for females have remainedrelatively stable over the years. While lungcancer mortality rates could be expected to risedue to the time lapse between smoking anddisease onset, it would not rise as high as whatwas predicted in Lopez’s smoking epidemicmodel due to the comprehensive anti-smokingmeasures Singapore has taken since the 1970s.

To consider the return on investment, theSingapore Government is evaluating the cost-effectiveness analysis of the NSCP. AssociateProfessor Doran is collaborating with HPB toexamine the economics of the government’sinvestment. The aim of the project is twofold:to demonstrate the role of economics inpriority setting; and, secondly, to quantify thenet-return of the NSCP in terms of avoidedtobacco-related health care expenses andpotential years of life saved.

Global Burden ofDisease: MentalDisorders and Illicit DrugUse Expert GroupResearch team (NDARC): LouisaDegenhardt, Jen McLaren,Bianca Calabria, Anna Roberts,Paul Nelson, Jessica Singleton,Johanna Thomas, Hammad Ali,Christina Briegleb, LindaSigmundsdottir, BridgettCallaghan, Umer Rana andAmber Sajjad

Research team (QCMHR): Harvey Whiteford, Amanda Bakerand An Pham

Researchers at the National Drug and AlcoholResearch Centre (NDARC) at the University ofNew South Wales and the Queensland Centrefor Mental Health Research (QCMHR) at theUniversity of Queensland are currentlyundertaking research that will determine theglobal burden of disease of illicit drug use anddependence and mental health disorders. Thisresearch is part of the broader Global Burdenof Disease, Injuries and Risk Factors Study(GBD Study), which involves the work of anumber of researchers from around the globe.

What is the GBD Study?The new GBD Study commenced in the firsthalf of 2007. It is the first major effort since theoriginal GBD Study to carry out a completesystematic assessment of the data on alldiseases and injuries, and producecomprehensive and comparable estimates ofthe burden of diseases, injuries and risk factorsfor two time periods, 1990 and 2005. Theproject will last three years, culminating with the publication of complete estimates in 2010.The GBD Study brings together a community ofexperts and leaders in epidemiology and otherareas of public health research from around theworld to measure current levels and recenttrends in all major diseases, injuries, and riskfactors, and to produce new andcomprehensive sets of estimates and easy-to-use tools for research and teaching.

GBD Management StructureA number of institutions from around the worldare involved in the GBD project. A Core Teamcoordinates the study, with input and strategicguidance provided by the External AdvisoryBoard. There are approximately 45 scientificExpert Groups for specific diseases, injuriesand risk factors, across five ‘clusters’ ofdiseases and injuries. Cluster C (Injuries andMental Health) is lead by Theo Vos, whooversees the co-leaders of the Mental Disordersand Illicit Drug Use Expert Group, LouisaDegenhardt (NDARC) and Harvey Whiteford (UQ).

Mental Disorders and Illicit DrugUse Expert GroupThe Mental Disorders and Illicit Drug Use ExpertGroup will conduct systematic reviews of theprevalence, incidence and duration of mental

health disorders and associated mortality anddisabling sequelae. Additionally, exposure andeffects of risk factors will be assessed. ExpertGroups will communicate their figures atdefined intervals with other Expert Groups and with the Core Team to ensure consistencyacross conditions and will be subjected toexternal peer review.

NDARC is collecting data on mortality from thefollowing drug groups: heroin and other opiates,amphetamine type substances, cocaine,cannabis and benzodiazepines. Prevalence,incidence and disability associated with use,abuse and dependence of these substances byregion is also being collected. The PopulationAttributable Fraction associated with illicit druguse for mortality and disability is being assessed.

The University of Queensland will be collectingdata on mental disorders other than substanceuse disorders. Prevalence, incidence, duration,mortality and disability estimates are of interest,as well as the Population Attributable Fractionassociated with mental disorders.

Guidelines forpsychosocially assistedpharmacotherapy ofopioid dependenceThe World Health Organization

The Economic and Social Council resolution2004/40 invited the World Health Organization,together with the United Nations Office onDrugs and Crime, “to develop and publishminimum requirements and internationalguidelines on psychosocially assistedpharmacological treatment of personsdependent on opioids, taking into accountregional developments in the field, in order to assist the member states concerned”.

The Guidelines for Psychosocially AssistedPharmacotherapy of Opioid Dependence havealso been developed in consultation with anexpert advisory group that comprise clinicaland research experts, including NDARCdirector, Professor Richard Mattick. Theguidelines were discussed and developed overthree key meetings. The first meeting involveddefining critical clinical questions, outcomesand guideline parameters, conductingsystematic reviews and GRADE evidenceprofiles. The second meeting focused onassessing the evidence and developingrecommendations based on evidence, clinicalpractice wisdom, and ethical principles. The thirdmeeting addressed the evaluation, disseminationand implementation of the guidelines.

The new guidelines advocate a health careapproach based on non-compulsory treatment,provision of effective treatment in health carefacilities with trained staff and a system ofclinical governance to ensure clinical standards,and treatment that addresses other health careneeds. The guidelines also advocate goodquality opioid substitution treatment, combinedwith psychosocial support, which is the mostcost-effective treatment option. The primary aimof this initiative is to close the gap betweenthose who need and those who are receivingeffective treatment.

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The harms associatedwith drug tourism innorthern ThailandAnjalee Cohen

Human travel is a significant contributor to theworldwide HIV/AIDS pandemic, including inAustralia. Approximately 20-25% of HIVinfections reported in Australia are acquiredoverseas. This has the potential to increase withthe growing numbers of Australians travelling toSoutheast Asia, particularly for commercial sexor drug use. There is an established associationbetween tourism and increased risk-taking,including drug and alcohol use and greatersexual risk behaviour. The role of sex tourism inspreading sexually transmitted diseases is welldocumented. Few studies, however, haveexamined drug use and its associated harms inthe context of tourism, particularly in Thailand, wheredrug tourism is common and HIV is widespread.

NDARC research fellow, Dr Anjalee Cohen, has received a 2009 Endeavour ResearchFellowship to conduct an ethnographic study on drug use among tourists in Pai, northernThailand, where illicit drugs are readily availableto travellers. The Australian GovernmentEndeavour Awards aim to develop mutualunderstanding and foster enduring linkagesbetween individuals, organisations and countries.As such, Dr Cohen will be based at Chiang MaiUniversity in northern Thailand for six monthsduring which time she will carry out her fieldworkin Pai. The study will aim to better understand thebehaviour of drug tourists and their drug usepatterns in order to help inform strategies forpreventing the spread of HIV in the Asia Pacificregion. It will also investigate the impact of drugtourism on the local Thai community.

In-depth interviews and participant observationwill be conducted with approximately 30tourists aged 18-35 years. Available data ontourists and drug use prevalence will becollected from law enforcement agents, localgovernment bodies, foreign embassies, andthe local tourism board. Subjects will initially berecruited at youth hostels, restaurants, cafes,bars, and other tourist entertainment venues. Asnowball sampling technique will be employed,whereby those interviewed will be asked tofacilitate contact with others. Validity of data willbe tested through data-source triangulation bycomparing data from different subjects orconfirming data with other subjects.

HIV incidence amongIDUs in northern ShanStates, Burma Kate Dolan, Richard Mattick and Sarah Larney

Aims: The aim of this AusAID funded project is to study the incidence of HIV transmissionamong injecting drug users (IDUs) and drugusers (DUs) living in the Lashio township,northern Shan States, as part of the monitoringmechanism to detect the impact of harm

reduction initiatives in this area. Changes in HIVrisk behaviours among IDUs and awareness of HIV/AIDS and sexually transmitted infectionsamong them and their families will also bestudied. In addition, perceptions of thecommunity on the environmental securityrelated to drug use will also be studied.

Design and Method: The program commencedin January 2008 and has been monitoring theHIV seropositivity status of drug users living inLashio township area, along with the HIV riskbehaviours among others. A cohort of drugusers has been recruited and they will befollowed up for two years to determine theincidence of HIV infection among IDUs andDUs, as well as other indicators of interest. Theproject is due for completion in December 2009.

Measuring the socio-economic impact ofdrugs, crime andcorruption in Lao PDR Chris Doran

The Lao PDR is a landlocked country with ageographical distribution of 236,800 squarekilometres that adjoins Vietnam, Thailand,Cambodia, China and Myanmar borders. Formany years Laos was a major producer andsupplier of the world’s illicit opiates. However,since the Prime Minister’s decree No.14 ofDecember 2000 mandating the totalelimination of opium, there have beenincreasing efforts to reduce opium. Since thatyear, the area of opium cultivation has beenreduced from 19,052 hectares to 1,500hectares. However, such apparent success inreducing opium is overshadowed by theincreasing role that the Lao PDR is takingwithin the South East Asian illicit drugtrafficking trade. Seizures of ATS detectedwithin Laos have increased dramatically in thepast decade, and are substantially higher thanneighbouring countries in the Mekong sub-region and Southeast Asian peninsula. Thisshift is one of many indicators that the countryis experiencing a high level of socio-economicchange, development and stress. As such, theLao PDR is currently in a fragile state oftransition amongst the rapid development ofneighbouring influencing countries: China,Thailand, Vietnam and Myanmar.

A United Nations Office on Drugs and Crime(UNODC) expert mission to Laos in September2007 identified, in conjunction with Government

counterparts and other stakeholders, therequirement to develop a methodology tomeasure the impact and cost of drugs andcrime, including corruption, on the socio-economic development of the country andprovide indicative data on costs based onavailable data. The UNODC commissionedAssociate Professor Doran to lead this programof research. The terms of reference for thisproject include:

Conduct and document a situationalanalysis on drugs, crime and corruption inLaos and linkages to the region; identify thevarious socio-economic areas impacted bydrugs, crime, and corruption;

Identify data gaps in order to inform thedevelopment of the necessary datacollection systems;

Based on certain assumptions, measure theextent and effect, as well as possible trendsof the impact; provide an indication of thecost of drugs, crime, including corruption,and the impact on the socioeconomicdevelopment of the Lao PDR;

Define the methodology involved whichwould contribute to preparation for future orexpanded studies; and,

Provide recommendations for future steps tobe taken.

Rapid assessment andresponse to drug use andHIV in MongoliaBradley Mathers, Effat MerghatiKhoei, Sarah Larney, Kate Dolan,Anthony Shakeshaft and AlexWodak

Aims: This project aimed to:

Determine the extent and nature of illicit druguse, including injecting drug use, in Mongolia;

Determine the public health aspects andimpact upon the community of illicit druguse including the role of injecting drug usein the spread of HIV in Mongolia; and,

Formulate recommendations to assist in thedevelopment of a comprehensivenationwide strategy addressing illicit druguse and HIV/AIDS in Mongolia

The rapid assessment and response (RAR)sought to inform the development of acomprehensive, nationwide strategy addressingillicit drug use and HIV/AIDS.

Design and Method: The project wasconducted in accordance with the methodologyoutlined in the WHO Rapid Assessment andResponse Guide on Psychoactive SubstanceUse and Sexual Risk Behaviour, the WHOResponse Guide on Injecting Drug Use and the WHO Rapid Assessment and ResponseTechnical Guide. A report on the project wasprepared for the World Health OrganizationRegional Office for the Western Pacific and the Mongolian Ministry of Health. cl

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The global epidemiologyof injecting drug use andHIV among people whoinject drugs: A systematicreview The Lancet, 2008, 372, 1733-1745

Mathers, B., Degenhardt, L.,Phillips, B., Wiessing, L., Hickman,M., Strathdee, S., Wodak, A.,Panda, S., Tyndall, M., Toufik, A.,Mattick, R. P., and the ReferenceGroup to the United Nations onHIV and Injecting Drug Use.

Background:Injecting drug use is an increasingly importantcause of HIV transmission in most countriesworldwide. Our aim was to determine theprevalence of injecting drug use amongindividuals aged 15–64 years, and of HIVamong people who inject drugs.

Methods:We did a systematic search of peer-reviewed(Medline, EMBASE, and PubMed/BioMedCentral), internet, and grey literaturedatabases; and data requests were made to UN agencies and international experts. 11 022 documents were reviewed, graded,and catalogued by the Reference Group tothe UN on HIV and Injecting Drug Use.

Findings:Injecting drug use was identified in 148countries; data for the extent of injecting druguse was absent for many countries in Africa,the Middle East, and Latin America. The presence of HIV infection among injectorshad been reported in 120 of these countries.Prevalence estimates of injecting drug usecould be ascertained for 61 countries,containing 77% of the world’s total populationaged 15–64 years. Extrapolated estimatessuggest that 15.9 million (range 11.0-21.2million) people might inject drugs worldwide;the largest numbers of injectors were found in China, the USA, and Russia, where mid-estimates of HIV prevalence among injectorswere 12%, 16%, and 37%, respectively. HIVprevalence among injecting drug users was20–40% in five countries and over 40% innine. We estimate that, worldwide, about 3.0million (range 0.8–6.6 million) people whoinject drugs might be HIV positive.

Interpretation:The number of countries in which the injectionof drugs has been reported has increasedover the last decade. The high prevalence ofHIV among many populations of injecting drugusers represents a substantial global health

challenge. However, existing data are far from adequate, in both quality and quantity,particularly in view of the increasingimportance of injecting drug use as a mode of HIV transmission in many regions.Copyright© 2008 Elsevier Inc.

Toward a global view ofalcohol, tobacco,cannabis, and cocaineuse: Findings from theWHO World MentalHealth SurveysPlos Medicine, 2008, 5 (7), 1053-1067

Degenhardt, L., Chiu, W. T.,Sampson, N., Kessler, R. C.,Anthony, J. C., Angermeyer, M.,et al.

Background:Alcohol, tobacco and illegal drug use causeconsiderable morbidity and mortality, butgood cross-national epidemiological data arelimited. This paper describes such data fromthe first 17 countries participating in theWHO’s World Mental Health (WMH) SurveyInitiative.

Methods:Household surveys with a combined samplesize of 85,052 were carried out in theAmericas (Colombia, Mexico, United States),Europe (Belgium, France, Germany, Italy,Netherlands, Spain, Ukraine), Middle East andAfrica (Israel, Lebanon, Nigeria, South Africa),Asia (Japan, People’s Republic of China), andOceania (New Zealand). The WHO CompositeInternational Diagnostic Interview (CIDI) wasused to assess the prevalence and correlatesof a wide variety of mental and substancedisorders. This paper focuses on lifetime useand age of initiation of tobacco, alcohol,cannabis and cocaine.

Findings:Alcohol had been used by most in theAmericas, Europe, Japan and New Zealand,with smaller proportions in the Middle East,Africa, and China. Cannabis use in the USAand New Zealand (42%) was far higher thanany other country. The USA was also an outlierin cocaine use (16%). Males were more likelythan females to have used drugs; and a sex-cohort interaction was observed, whereby notonly were younger cohorts more likely to useall drugs, but the male-female gap wasclosing in more recent cohorts. There was alsoa prolongation of the period of risk for druguse initiation, persisting later into adulthood,among more recent cohorts. Associations withsociodemographic variables were consistentacross countries, as were age of onset curves.

Interpretation:Globally, drug use is not distributed evenlyand is not simply related to drug policy, sincecountries with stringent user-level illegal drugpolicies did not have lower levels of use thancountries with liberal ones. Sex differenceswere consistently documented, but aredecreasing in more recent cohorts, who alsohave higher levels of illegal drug use andextensions in the period of risk for initiation.Copyright© 2008 Public Library of Science.

The rise ofmethamphetamine inSoutheast and East AsiaDrug and Alcohol Review, 2008, 27, 220– 228

McKetin, R., Kozel, N., DouglasJ., Ali R., Vicknasingam B., LundJ., et al.

Introduction and Aims:Southeast and East Asia has become a globalhub for methamphetamine production andtrafficking over the past decade. This paperdescribes the rise of methamphetamine supplyand to what extent use of the drug is occurringin the region.

Method and Design:The current review uses data collectedthrough the Drug Abuse Information Networkfor Asia and the Pacific (DAINAP) and otheravailable sources to analyse retrospectivelymethamphetamine trends within Southeastand East Asia.

Results:Southeast and East Asia has experienced a methamphetamine epidemic in the pastdecade which began around 1997 andpeaked in 2000 – 2001. While the situation has since stabilised in many countries,methamphetamine trafficking and use are stillincreasing in parts of the Mekong region andthere is evidence of large-scale manufacture in Cambodia, Indonesia, Malaysia and thePhilippines. Methamphetamine is typicallysmoked or ingested, but injection of the drugis apparent.

Conclusion:While the peak of the methamphetamineepidemic has passed in parts of Southeast and East Asia, attention is needed to minimisethe potential consequences of spreadingmethamphetamine production, trafficking anduse in the Mekong region and in the peninsularand archipelago of Southeast Asia. Copyright©

2008 Informa Healthcare.

abstracts

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HIV in prison in low-income and middle-income countriesLancet Infectious Diseases, 2007, 7, 32-41

Dolan, K., Kite, B., Black, E.,Aceijas, C., Stimson, G. V., forthe Reference Group onHIV/AIDS Prevention and Careamong Injecting Drug Users inDeveloping and TransitionalCountries

High prevalence of HIV infection and the over-representation of injecting drug users (IDUs) inprisons combined with HIV risk behaviourcreate a crucial public-health issue forcorrectional institutions and, at a broader level,

the communities in which they are situated.However, data relevant to this problem arelimited and difficult to access. We reviewedimprisonment, HIV prevalence, and theproportion of prisoners who are IDUs in 152low-income and middle-income countries.Information on imprisonment was obtained for142 countries. Imprisonment rates ranged from23 per 100 000 population in Burkina Faso to532 per 100 000 in Belarus and Russia.Information on HIV prevalence in prisons wasfound for 75 countries. Prevalence was greaterthan 10% in prisons in 20 countries. Eightcountries reported prevalence of IDUs in prisonof greater than 10%. HIV prevalence amongIDU prisoners was reported in eight countriesand was greater than 10% in seven of those.Evidence of HIV transmission in prison wasfound for seven low-income and middle-incomecountries. HIV is a serious problem for many

countries, especially where injecting drug useoccurs. Because of the paucity of dataavailable, the contribution of HIV within prisonsettings is difficult to determine in many low-income and middle-income countries.Systematic collection of data to inform HIVprevention strategies in prison is urgentlyneeded. The introduction and evaluation of HIVprevention strategies in prisons are warranted.Copyright© 2007 Elsevier Inc. cl

upcoming eventsAPSAD 2008 ConferenceThe Australasian Professional Society onAlcohol and other Drugs (APSAD) Conference2008 is taking place at the Sydney Conventionand Exhibition Centre between the 23rd and26th November this year. The conference hasbeen organised by a committee of experts inthe drug and alcohol field, including directorof NDARC and conference convener ProfessorRichard Mattick, and NDARC’s Dr RebeccaMcKetin, Dr Katherine Mills, Ms MarianShanahan, Dr Wendy Swift and Dr Laura Vogl.The conference will feature international andnational keynote speakers who will focus onnew treatment, prevention and policyapproaches to the drug and alcohol field. Abroad range of cutting-edge drug and alcoholresearch will be presented by numerousexperts in the field.

The APSAD 2008 Conference will include arange of clinical workshops/master classes toenhance skills acquisition and knowledgetransfer. There will also be a significant programof poster presentations to increase the ability ofpresenters and delegates to interact anddiscuss research findings of shared interest.

The Scientific Program will focus on evidence,policy and practice. The Conference will be ofinterest to workers and clinicians in drug andalcohol and mental health services; researchers,health and other professionals with an interest indrug and alcohol issues; those engaged inhealth policy development and implementation;health economists; youth workers; regulatoryand operational officers involved in drug lawenforcement and corrective services;

pharmaceutical companies developing andmarketing pharmacotherapies; organisationsrepresenting consumers; and, members andcolleagues of APSAD. For further informationvisit the APSAD website:http://www.apsad2008.com

A Workshop on Illicit Drug Harm IndexesThe Drug Policy Modelling Program is holding aone-day international workshop about Illicit DrugHarm Indexes on Wednesday 4th March, 2009,at the UNODC offices in Vienna. The workshopis being held as a satellite workshop to theInternational Society for the Study of Drug Policy(ISSDP) 3rd Annual Conference.

Comparisons within a country or region overtime, between regions or countries and acrossdomains of policy initiative: law enforcement,treatment, harm reduction and prevention are alldifficult without a composite Index. Measuringthe diverse aspects of drug policy involvescombining various consequences (such ashealth and crime outcomes) with prevalenceand consumption into a single Index.

The drugs field has been engaged in workacross the globe on composite Drug Indexes.There is the UK Drug Harm Index, theUNODC Illicit Drug Index, the New ZealandDrug Harm Index, the Australian Drug PolicyIndex (DPMP) and the AFP Drug Harm Indexto mention a few. The work is difficult and hasmany methodological and conceptualchallenges. To date, there has not been anattempt to bring together different countriesand research teams to share experiences inindex development and use.

The purpose of this workshop is to provide aforum to discuss the different approaches to aDrug Harm Index, share problem-solving andprovide opportunities for potential futurecollaborations. The workshop is beingorganised by Alison Ritter, Director, Drug PolicyModelling Program, NDARC, University of NewSouth Wales. Please contact her for furtherinformation (alison.ritter@unsw.edu.au).

IHRA’s 20th InternationalConferenceThe International Harm Reduction Association’s(IHRA) 20th international conference will be heldin Thailand, at the Queen Sirikit NationalConvention Centre in Bangkok from the 19th tothe 23rd April, 2009. Over five days, thisconference will bring together harm reductionand human rights advocates, UNrepresentatives, researchers, health and legalprofessionals, drug user advocates and themedia to discuss and promote harm reduction.For nearly twenty years, these events have beenthe key meeting point for the dissemination ofharm reduction ideas and practice, and havehelped to raise the importance of harmreduction worldwide. The conference theme for2009 will be “Harm Reduction and HumanRights”. For further information visit the IHRAwebsite: http://www.ihra.net cl

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For more information on or copies of thesepublications, please visit the NDARCwebsite http://ndarc.med.unsw.edu.au

Technical ReportsCalabria, B., Phillips, B., Singleton, J.,Mathers, B., Congreve, E., Degenhardt, L., etal. (2008). Searching the grey literature toaccess information on drug and alcoholresearch, NDARC Technical Report. Sydney:National Drug and Alcohol Research Centre.

Cogger, S., McKetin, R., Ross, J., & Najman,J. (2008). Methamphetamine TreatmentEvaluation Study (MATES) STI Findings from theBrisbane Site, NDARC Technical Report.Sydney: National Drug and Alcohol ResearchCentre.

Hetherington, K., & McKetin, R. (2008). Thecontribution of cannabis use to psychoticsymptoms among methamphetamine treatmententrants, NDARC Technical Report. Sydney,NSW: National Drug and Alcohol ResearchCentre.

Larney, S., & Dolan, K. (2008). Demandreduction strategies in closed settings in China,Indonesia and Vietnam, NDARC TechnicalReport. Sydney: National Drug and AlcoholResearch Centre.

Simpson, M., Copeland, J., & Lawrinson, P.(2008). The Australian Alcohol TreatmentOutcome Measure (AATOM-C) STI Findings ofthe 12-month feasibility study, NDARC TechnicalReport. Sydney: National Drug and AlcoholResearch Centre.

Wardlaw, G. (2008). Final report: Illicit drugreporting system STI Consultant’s report to theCommonwealth Department of Human Servicesand Health, NDARC Technical Report. Sydney,NSW: National Drug and Alcohol ResearchCentre.

Published Articles,Chapters and BooksFor more information on or copies ofthese publications, please contact therelevant researcher

Anderson, R., Haas, M., & Shanahan, M.(2008). The cost-effectiveness of cervicalscreening in Australia: what is the impact ofscreening at different intervals or over a differentage range? Australian and New ZealandJournal of Public Health 32, 43-52.

Bammer, G., Smithson, M., & The GoolabriGroup. (2008). The nature of uncertainty (A.Ritter, Trans.). In G. Bammer & M. Smithson(Eds.), Uncertainty and risk: Multi-disciplinaryperspectives (pp. 289-303). London: Earthscan.

Bammer, G., & The Goolabri Group. (2008).Improving the management of ignorance anduncertainty: A case illustrating integration incollaboration (A. Ritter, Trans.). In G. Bammer &M. Smithson (Eds.), Uncertainty and risk: Multi-disciplinary perspectives (pp. 421-437).London: Earthscan.

Bell, J. (2008). Speciality recognition of addictionmedicine in Australia. Addiction 103, 701-702.

Bell, J. R., Ryan, A., Mutch, C., Batey, R., &Rea, F. (2008). Optimising the benefits ofunobserved dose administration for stableopioid maintenance patients: Follow-up of arandomised trial. Drug and AlcoholDependence 96, 183-186.

Bleeker, A., & Silins, E. (2008). Faith, love andtheory: Peer-led interventions for ‘party drug’users. In D. Moore & P. Dietze (Eds.), Drugs andpublic health (pp. 29-38). Melbourne: OxfordUniversity Press.

Burns, L., Mattick, R., & Wallace, C. (2008).Smoking patterns and outcomes in a populationof pregnant women with other substance usedisorders. Nicotine & Tobacco Research 10,969-974.

Campbell, I., & Chalmers, J. (2008). Job qualityand part-time work in the retail industry: AnAustralian case study. International Journal ofHuman Resource Management 19, 487-500.

Conroy, E., Kimber, J., Dolan, K., & Day, C.(2008) An examination of the quality of lifeamong rural and outer metropolitan injectingdrug users in NSW, Australia. AddictionResearch & Theory 16, 607-617.

Cruickshank, C. C., Montebello, M. E., Dyer, K.R., Quigley, A., Blaszczyk, J.,Tomkins, S., et al.(2008). A placebo-controlled trial of mirtazapinefor the management of methamphetaminewithdrawal. Drug and Alcohol Review 27, 326-333.

Darke, S. (2008). From the can to the coffin:Deaths among recently released prisoners.Addiction 103, 256-257.

Darke, S. (2008). Truth is not always found inthe laboratory. Addiction 103, 1066-1067.

Darke, S., & Duflou, J. (2008). Toxicology andcircumstances of death of homicide victims inNew South Wales, Australia 1996-2005. Journalof Forensic Sciences 53, 447-451.

Darke, S., Kaye, S., McKetin, R., & Duflou, J.(2008). Major physical and psychological harmsof methamphetamine use. Drug and AlcoholReview 27, 253-262.

Darke, S., Ross, J., Williamson, A., Mills, K. L.,Havard, A., & Teesson, M. (2008). Injecting andnoninjecting heroin administration: Transitionsand treatment outcomes across 36 months.Journal of Drug Issues 38, 543-557.

Degenhardt, L. (2008). Drug use anddepression: Evidence on the association andpotential reasons to explain it. In S. Allsop (Ed.),Drug use and mental health: Effectiveresponses to co-occurring drug and mentalhealth problems (pp. 130-142). Melbourne: IPCommunications.

Degenhardt, L. (2008). Illicit drug use and theburden of disease. In K. Heggenhougen & S.Quah (Eds.), International Encyclopedia ofPublic Health (Vol. 3, pp. 523-530). San Diego:Academic Press.

Degenhardt, L., Baker, A., & Maher, L. (2008).Methamphetamine: geographic areas andpopulations at risk, and emerging evidence foreffective interventions. Drug and Alcohol Review27, 217-219.

Degenhardt, L., Bohnert, K. M., & Anthony, J.C. (2008). Assessment of cocaine and otherdrug dependence in the general population:“Gated” versus “ungated” approaches. Drugand Alcohol Dependence 93, 227-232.

Degenhardt, L., Chiu, W.T., Sampson, N.,Kessler, R. C., Anthony, J. C., Angermeyer, M.,et al. (2008). Toward a global view of alcohol,tobacco, cannabis, and cocaine use: Findingsfrom the WHO World Mental Health Surveys.Plos Medicine 5, 1053-1067.

Degenhardt, L., Coffey, C., Carlin, J. B., Swift,W., & Patton, G. C. (2008). Are diagnosticorphans at risk of developing cannabis abuseor dependence? Four-year follow-up of youngadult cannabis users not meeting diagnosticcriteria. Drug and Alcohol Dependence 92, 86-90.

Degenhardt, L., & Dunn, M. (2008). Theepidemiology of GHB and ketamine use in anAustralian household survey. InternationalJournal of Drug Policy 19, 311-316.

Degenhardt, L., Gibson, A., & Mattick, R.(2008). Depot naltrexone use for opioiddependence in Australia: Large-scale use of anunregistered medication in the absence of dataon safety and efficacy. Drug and AlcoholReview 27, 1-3.

recent publications

Degenhardt, L., & Hall, W. (2008). Australianheroin seizures and the causes of the 2001heroin shortage. International Journal of DrugPolicy 19, 293-294.

Degenhardt, L., & Hall, W. D. (2008). Theadverse effects of cannabinoids: implications for use of medical marijuana. Canadian MedicalAssociation Journal 178, 1685-1686.

Degenhardt, L., Kinner, S. A., Roxburgh, A.,Black, E., Bruno, R., Fetherston, J., et al.(2008). Drug use and risk among regularinjecting drug users in Australia: Does agemake a difference? Drug and Alcohol Review27, 357-360.

Degenhardt, L., Roxburgh, A., Black, E.,Bruno, R., Campbell, G., Kinner, S., et al.(2008). The epidemiology of methamphetamineuse and harm in Australia. Drug and AlcoholReview 27, 243-252.

Degenhardt, L., Roxburgh, A., Van Beek, I.,Hall, W. D., Robinson, M. K. F., Ross, J., et al.(2008). The effects of the market withdrawal oftemazepam gel capsules on benzodiazepineinjecting in Sydney, Australia. Drug and AlcoholReview 27, 145-151.

Dierker, L., He, J., Kalaydjian, A., Swendsen,J., Degenhardt, L., Glantz, M., et al. (2008).The importance of timing of transitions for risk of regular smoking and nicotine dependence.Annals of Behavioral Medicine 36, 87-92.

Dillon, P. (2008). Working with the media onalcohol and other drug issues: the Australianexperience. In D. Moore & P. Dietze (Eds.),Drugs and public health (pp. 191-200).Melbourne: Oxford University Press.

Doran, C. M. (2008). Economic evaluation ofinterventions to treat opiate dependence – Areview of the evidence. Pharmacoeconomics 26,371-393.

Doran, C. M., & Shakeshaft, A. P. (2008). Usingtaxes to curb drinking in Australia. Lancet 372,701-702.

Dray, A., Mazerolle, L., Perez, P., & Ritter, A.(2008). Drug law enforcement in an agent-based model: Simulating the disruption tostreet-level drug markets. In L. Liu & J. Eck(Eds.), Artificial crime analysis systems: Usingcomputer simulations and geographicinformation systems (pp. 352-371). Hershey,PA.: Idea Group Publishing.

Essau, C. & Hutchinson, D. (2008). Alcoholuse, abuse and dependence. In C. Essau (Ed.),Adolescent addiction: Epidemiology,assessment and treatment (pp. 61-115).Amsterdam: Elsevier.

Gerard, K., Shanahan, M., & Louviere, J.(2008). Using discrete choice modelling toinvestigate breast screening participation. In M.Ryan, K. Gerard & M. Amaya-Amaya (Eds.),Using discrete choice experiments to valuehealth and health care (pp. 117-137).Dordrecht, The Netherlands: Springer.

Gibson, A., Degenhardt, L., Mattick, R., Ali, R.,White, J., & O’Brien, S. (2008). Exposure toopioid maintenance treatment reduces long-term mortality. Addiction 103, 462-468.

Hall, W., & Degenhardt, L. (2008). Cannabisuse and the risk of developing a psychoticdisorder. World Psychiatry 7, 68-71.

Hall, W., Degenhardt, L., Gibson, A., & Mattick,R. (2008). Response to Degenhardt et al.:‘Depot naltrexone use for opioid dependence inAustralia: large-scale use of an unregisteredmedication in the absence of data on safety andefficacy’. Drug and Alcohol Review 27, 448-449.

Hall, W., Degenhardt, L., & Patton, G. (2008).Adolescent cannabis abuse and dependence.In C. Essau (Ed.), Adolescent addiction:Epidemiology, assessment and treatment(pp. 117-147). Amsterdam: Elsevier.

Hall, W. D., & Mattick, R. (2008). Oralsubstitution treatments for opioid dependence.Lancet 371, 2150-2151.

Havard, A., Shakeshaft, A., & Sanson-Fisher, R.(2008). Systematic review and meta-analyses of strategies targeting alcohol problems inemergency departments: Interventions reducealcohol-related injuries. Addiction 103, 368-376.

Hines, S.,Theodorou, S., Williamson, A.,Fong, D., & Curry, K. (2008). Management ofacute pain in methadone maintenance therapyin-patients. Drug and Alcohol Review 27, 519-523.

Hutchinson, D., Alati, R., Najman, J. M.,Mattick, R., Bor, W., O’Callaghan, M., et al.(2008). Maternal attitudes in pregnancy predictdrinking initiation in adolescence. Australian andNew Zealand Journal of Psychiatry 42, 324-334.

Indig, D., Copeland, J., & Conigrave, K. M.(2008). Young people who attend specialistalcohol treatment: who are they and do theyneed special treatment? Australian and NewZealand Journal of Public Health 32, 336-340.

Islam, M. M., Stern,T., Conigrave, K. M., &Wodak, A. (2008). Client satisfaction and riskbehaviours of the users of syringe dispensingmachines: a pilot study. Drug and AlcoholReview 27, 13-19.

Kaye, S., Darke, S., Duflou, J., & McKetin, R.(2008). Methamphetamine-related fatalities inAustralia: Demographics, circumstances,toxicology and major organ pathology.Addiction 103, 1353-1360.

Kimber, J., Hickman, M., Degenhardt, L.,Coulson,T., & van Beek, I. (2008). Estimatingthe size and dynamics of an injecting drug userpopulation and implications for health servicecoverage: comparison of indirect prevalenceestimation methods. Addiction 103, 1604-1613.

Kinner, S. A., & Degenhardt, L. (2008). Crystalmethamphetamine smoking among regularecstasy users in Australia: increases in use andassociations with harm. Drug and AlcoholReview 27, 292-300.

Large, M., Farooq, S., Nielssen, O., & Slade,T.(2008). Relationship between gross domesticproduct and duration of untreated psychosis in low- and middle-income countries. BritishJournal of Psychiatry 193, 272-278.

Lamb, C. E. F., Boers, M., Owens, A.,Copeland, J., & Sultana,T. (2008). Exploringexperiences and attitudes about health carecomplaints among pregnant women, mothersand staff at an Opioid Treatment Service.Australian Health Review 32, 66-75.

Larney, S., & Dolan, K. (2008). An exploratorystudy of needlestick injuries among Australianprison officers. International Journal of PrisonerHealth 4, 164-168.

Larney, S., & Dolan, K. (2008). Increasedaccess to opioid substitution treatment inprisons is needed to ensure equivalence ofcare. Australian and New Zealand Journal ofPublic Health 32, 86-87.

Lee, K. S. K., Conigrave, K. M., Clough, A. R.,Wallace, C., Silins, E., & Rawles, J. (2008).Evaluation of a community-driven preventiveyouth initiative in Arnhem Land, NorthernTerritory, Australia. Drug and Alcohol Review 27,75-82.

Lee, N., Kay-Lambkin, F., McKetin, R., &Baker, A. (2008). Everything old is new again:The application of drug treatment to theemerging challenge of methamphetamine useand dependence. In D. Moore & P. Dietze(Eds.), Drugs and public health (pp. 73-84).Melbourne: Oxford University Press.

Lemon, J. (2008). Residual effects of alcohol onskilled performance. Alcohol and Alcoholism 43,498-498.

Martin, G., & Copeland, J. (2008). Theadolescent cannabis check-up: Randomizedtrial of a brief intervention for young cannabisusers. Journal of Substance Abuse Treatment34, 407-414.

Mathers, B., Degenhardt, L., Phillips, B.,Wissing, L., Hickman, M., Strathdee, S. A., etal. (2008). Global epidemiology of injecting druguse and HIV among people who inject drugs: Asystematic review. The Lancet 372, 1733-1745.

Mattick, R., & O’Brien, S. (2008). Alcohol anddrug use disorders and the anxiety disorders:Co-occurrence, relationship, assessment andtreatment implications. In S. Allsop (Ed.), Druguse and mental health: Effective responses toco-occurring drug and mental health problems(pp. 121-129). Melbourne: IP Communications.

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Mattick, R. P., Kimber, J., Breen, C., & Davoli,M. (2008). Buprenorphine maintenance versusplacebo or methadone maintenance for opioiddependence. Cochrane Database of SystematicReviews 2.

McEvoy, P. M., & Shand, F. (2008). The effect ofcomorbid substance use disorders on treatmentoutcome for anxiety disorders. Journal ofAnxiety Disorders 22, 1087-1098.

McKetin, R. (2008). Methamphetamine precursorregulation: Are we controlling or diverting thedrug problem? Addiction 103, 521-523.

McKetin, R., Kelly, E., McLaren, J., &Proudfoot, H. (2008). Impaired physical healthamong methamphetamine users in comparisonwith the general population: The role ofmethamphetamine dependence and opioid use.Drug and Alcohol Review 27, 482-489.

McKetin, R., Kozel, N., Douglas, J., Ali, R.,Vicknasingam, B., Lund, J., et al. (2008). Therise of methamphetamine in Southeast and EastAsia. Drug and Alcohol Review 27, 220-228.

McKetin, R., McLaren, J., Lubman, D. I., &Hides, L. (2008). Hostility amongmethamphetamine users experiencingpsychotic symptoms. American Journal onAddictions 17, 235-240.

McKetin, R., Ross, J., Kelly, E., Baker, A., Lee,N., Lubman, D. I., et al. (2008). Characteristicsand harms associated with injecting versussmoking methamphetamine amongmethamphetamine treatment entrants. Drug and Alcohol Review 27, 277-285.

McLaren, J., Swift, W., Dillon, P., & Allsop, S.(2008). Cannabis potency and contamination: A review of the literature. Addiction 103, 1100-1109.

Mills, K. L., Hodge, W., Johansson, K., &Conigrave, K. M. (2008). An outcomeevaluation of the New South Wales Sober Driver Programme: A remedial programme for recidivist drink drivers. Drug and AlcoholReview 27, 65-74.

Mills, K. L.,Teesson, M., Ross, J., & Darke, S.(2008). Predictors of trauma and PTSD amongheroin users: A prospective longitudinalinvestigation. Journal of Drug Issues 38, 585-599.

Mitcheson, L., McCambridge, J., Byrne, A.,Hunt, N., & Winstock, A. (2008). Sexualhealth risk among dance drug users: Cross-sectional comparisons with nationallyrepresentative data. International Journal of Drug Policy 19, 304-310.

O’Brien, S., Day, C., Black, E., & Dolan, K.(2008) Injecting drug users’ understanding ofhepatitis C. Addictive Behaviors 33, 1602-1605.

Proudfoot, H., & Teesson, M. (2008).Challenges posed by co-occurring disorders inthe clinical and service systems. In S. Allsop(Ed.), Drug use and mental health: Effectiveresponses to co-occurring drug and mentalhealth problems (pp. 65-77). Melbourne: IPCommunications.

Rasmussen, N. (2008). America’s firstamphetamine epidemic 1929-1971 – Aquantitative and qualitative retrospective withimplications for the present. American Journal of Public Health 98, 974-985.

Richardson, K., Baillie, A., Reid, S., Morley, K.,Teesson, M., Sannibale, C., et al. (2008). Doacamprosate or naltrexone have an effect ondaily drinking by reducing craving for alcohol?Addiction 103, 953-959.

Riddell, S., Shanahan, M., Degenhardt, L., &Roxburgh, A. (2008). Estimating the costs ofdrug-related hospital separations in Australia.Australian and New Zealand Journal of PublicHealth 32, 156-161.

Riddell, S., Shanahan, M., Degenhardt, L.,& Roxburgh, A. (2008). A review of the use of US-derived aetiological fractions in anAustralian setting for antenatal problems relatedto cocaine use. Australian and New ZealandJournal of Public Health 32, 393-394.

Ritter, A. (2008). Heroin: Injected withuncertainty. In G. Bammer & M. Smithson(Eds.), Uncertainty and risk: Multidisciplinaryperspectives on risk (pp. 157-169). London:Earthscan.

Ritter, A. (2008). Speaking truth to power. Drug and Alcohol Review, 27(2), 113-114.

Ritter, A., & McDonald, D. (2008). Illicit drug policy: Scoping the interventions andtaxonomies. Drugs: Education Prevention and Policy 15, 15-35.

Roxburgh, A., & Degenhardt, L. (2008).Characteristics of drug-related hospitalseparations in Australia. Drug and AlcoholDependence 92, 149-155.

Roxburgh, A., Degenhardt, L., Copeland, J.,& Larance, B. (2008). Drug dependence andassociated risks among female street-based sexworkers in the greater Sydney area, Australia.Substance Use & Misuse 43, 1202-1217.

Shearer, J. (2008). The principles of agonistpharmacotherapy for psychostimulantdependence. Drug and Alcohol Review 27,301-308.

Shearer, J., Johnston, J., Fry, C. L., Kaye, S.,Dillon, P., Dietze, P., et al. (2008). An AustralianProfile on Cocaine Supply. The Howard Journal47, 67-88.

Silins, E., Sannibale, C., Larney, S., Wodak, A.,& Mattick, R. (2008). Residential detoxification:Essential for marginalised, severely alcohol- anddrug-dependent individuals. Drug and AlcoholReview 27, 414-419.

Smithson, M., Bammer, G., & the GoolabriGroup. (2008). Coping and managing underuncertainty (A. Ritter, Trans.). In G. Bammer &M. Smithson (Eds.), Uncertainty and risk: Multi-disciplinary perspectives (pp. 321-333).London: Earthscan.

Smithson, M., Bammer, G., & the GoolabriGroup. (2008). Uncertainty metaphors, motivesand morals (A. Ritter, Trans.). In G. Bammer &M. Smithson (Eds.), Uncertainty and risk: Multi-disciplinary perspectives (pp. 305-320).London: Earthscan.

Swift, W., Coffey, C., Carlin, J. B., Degenhardt,L., & Patton, G. C. (2008). Adolescent cannabisusers at 24 years: Trajectories to regular weeklyuse and dependence in young adulthood.Addiction 103, 1361-1370.

Teesson, M. (2008). Recognition andprevention of major mental and substance usedisorders. Addiction 103, 857-858.

Teesson, M., Mills, K., Ross, J., Darke, S.,Williamson, A., & Havard, A. (2008). Theimpact of treatment on 3 years’ outcome forheroin dependence: Findings from theAustralian Treatment Outcome Study (ATOS).Addiction 103, 80-88.

Thomson, C. L., Morley, K. C.,Teesson, M.,Sannibale, C., & Haber, P. S. (2008). Issueswith recruitment to randomised controlled trialsin the drug and alcohol field: A literature reviewand Australian case study. Drug and AlcoholReview 27, 115-122.

Winstock, A. R. (2008). Buprenorphine use bythe smoking route in gaols in NSW. Drug andAlcohol Review 27, 449-450.

Winstock, A. R., Lea,T., & Sheridan, J. (2008).Patients’ help-seeking behaviours for healthproblems associated with methadone andbuprenorphine treatment. Drug and AlcoholReview 27, 393-397.

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staff listNational Drug and AlcoholResearch Centre

Staff as of 1 October, 2008

Richard Mattick Director, Professor

Jan Copeland Director NCPIC,Professor

Shane Darke Professor

Louisa Degenhardt Professor

Maree Teesson Professor

Kate Dolan Associate Professor

Chris Doran Associate Professor

Alison Ritter Associate Professor

Anthony Shakeshaft Associate Professor

Lucy Burns Senior Lecturer

John Howard Senior Lecturer

Katherine Mills Senior Lecturer

Joanne Ross Senior Lecturer

Wendy Swift Senior Lecturer

Jenny Chalmers Senior ResearchFellow

Rebecca McKetin Senior ResearchFellow

Tim Slade Senior ResearchFellow

Suzanne Czech Lecturer

David Bright Research Fellow

Anton Clifford Research Fellow

Anjalee Cohen Research Fellow

Caitlin Hughes Research Fellow

Delyse Hutchinson Research Fellow

Sharlene Kaye Research Fellow

Frances Kay-Lambkin Research Fellow

Jim Lemon Research Fellow

Kristy Martire Research Fellow

Heather Proudfoot Research Fellow

Claudia Sannibale Research Fellow

Stephanie Taplin Research Fellow

Laura Vogl ARC Research Fellow

Natacha Carragher Post Doctoral Research Fellow

Matthew Dunn Associate Lecturer

Amy Johnston Research Associate

Kylie Sutherland Research Associate

Paul Dillon National CommunicationsManager (NCPIC)

Michael Lodge Senior Research Policy Officer

Shale Preston Executive Officer

Annie Bleeker National CommunityTraining Manager(NCPIC)

Etty Matalon National Clinical TrainingManager (NCPIC)

Sabine Merz Research Psychologist

Julia Rosenfeld Research Psychologist

Kirsty Taylor Research Psychologist

Hammad Ali Senior Research Officer

Anthony Arcuri Senior Research Officer

Emma Black Senior Research Officer

Desiree Boughtwood Senior Research Officer

Courtney Breen Senior Research Officer

Elizabeth Conroy Senior Research Officer

Catherine Deans Senior Research Officer

Amie Frewen Senior Research Officer

Peter Gates Senior Research Officer

Amy Gibson Senior Research Officer

Briony Larance Senior Research Officer

Elizabeth Maloney Senior Research Officer

Bradley Mathers Senior Research Officer

Jennifer McLaren Senior Research Officer

Rachel Ngui Senior Research Officer

Susannah O’Brien Senior Research Officer

Michael Otim Senior Research Officer

Deborah Randall Biostatistician/Senior Research Officer

Sally Rooke Senior Research Officer

Amanda Roxburgh Senior Research Officer

Natasha Sindicich Senior Research Officer

Jenny Stafford Senior Research Officer

Delphine Bostock Matusko Research Officer

Bianca Calabria Research Officer

Mark Deady Research Officer

Philippa Farrugia Research Officer

Katrina Grech Research Officer

Rachel Grove Research Officer

Karina Hickey Research Officer

Aspasia Karageorge Research Officer

Erin Kelly Research Officer

Stephanie Love Research Officer

Maree-Andree Peek-OLeary Research Officer

Benjamin Phillips Research Officer

John Redmond Research Officer

Anna Roberts Research Officer

Lisa Robins Research Officer

Laura Scott Research Officer

Rachel Sutherland Research Officer

Michelle Torok Research Officer

Clare Chenoweth Communications Officer(NCPIC)

Emma Barrett Doctoral Candidate

Joshua Byrnes Doctoral Candidate

Alys Havard Doctoral Candidate

Devon Indig Doctoral Candidate

Sarah Larney Doctoral Candidate

Kristie Mammen Doctoral Candidate

Francis Matthew-Simmons Doctoral Candidate

Louise Mewton Doctoral Candidate

Hector Navarro Doctoral Candidate

Paul Nelson Doctoral Candidate

Nicola Newton Doctoral Candidate

Marian Shanahan Doctoral Candidate

Fiona Shand Doctoral Candidate

James Shearer Doctoral Candidate

Edmund Silins Doctoral Candidate

Melanie Simpson Doctoral Candidate

Eva Congreve Librarian

Ross Beck IT Officer

Alan Louie IT Officer

Lin Chin Senior Finance Officer

Crisanta Corpus Senior Finance Officer

Colleen Faes Executive Assistant

Julie Hodge Executive Assistant

Gem Mathieu Executive Assistant

Anton Perkins Administrative Officer

Carla Santos Executive Assistant

Caroline Santoso Administrative Assistant

CONJOINTSWayne Hall Professor

James Bell Associate Professor

Kate Conigrave Associate Professor

Johan Duflou Associate Professor

Paul Haber Associate Professor

Amanda Baker Associate Professor

Ingrid Van Beek Senior Lecturer

Jeff Ward Senior Lecturer

Adam Winstock Senior Lecturer

VISITINGRobert Ali Visiting Associate

Professor

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