Courtney Breen

UNSW Sydney | UNSW · National Drug and Alcohol Research Centre

Objectives: To evaluate the impact of a multi‐component, Aboriginal‐led strategy to reduce alcohol‐related criminal incidents for Aboriginal people in four rural/remote communities in New South Wales (NSW), Australia. Methods: A retrospective multiple baseline design (MBD), using interrupted time series analysis of routinely collected crime data...

Aim To determine characteristics of death in children with neonatal abstinence syndrome (NAS). Methods A population‐based linkage study of children from birth to 13 years of age in New South Wales (NSW), Australia, born 1 July 2000 to 31 December 2011. Infants with an International Statistical Classification of Diseases and Related Problems, Austr...

Aboriginal Australians have experienced trauma, racism and disempowerment as a result of the legacies of colonisation and dispossession. One of the most visible manifestations of this is the disproportionately higher rate of substance-related harms compared to non-Aboriginal Australians. These harms impact the social and emotional wellbeing of Abor...

Introduction and aims: Aboriginal residential rehabilitation services provide healing for Aboriginal people who misuse substances. There is limited available research that empirically describes client characteristics of these services. This study examined 5 years of data of a remote Aboriginal residential rehabilitation service. Design and method...

Background The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and larg...

Objective: To examine the purchasing and supply patterns of new psychoactive substance (NPS) consumers in Australia. Method: Data were obtained from a self-selected sample of 296 past-year NPS consumers, with comparisons made across dimethyltryptamine (n = 104), 2C-x (n = 59), NBOMe (n = 27), and synthetic cannabinoid (n = 22) users. Results:...

Introduction: Driving following illicit drug consumption ('drug-driving') is a potential road safety risk. Roadside drug testing (RDT) is conducted across Australia with the dual aims of prosecuting drivers with drugs in their system and deterring drug-driving. We examined trends over time in self-reported past six-month drug-driving among sentine...

Introduction: Online drug markets operating on the 'darknet' ('cryptomarkets') facilitate the trade of illicit substances at an international level. The present study assessed the longitudinal impact on cryptomarket trading of two major disruptions: a large international law enforcement operation, 'Operation Onymous'; and the closure of the larges...

Background and objectives: Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). Methods: Linked analysis of health and curriculum-based test data for all...

The National Illicit Drug Indicators Project (2016 Report). Funded by the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund.

Background: This study analyses the incidence of Neonatal Abstinence Syndrome (NAS) in a large geographically defined population in Australia. Method: Database linkage analysis of all births between 2000 and 2011 in New South Wales (NSW), Australia. The diagnosis of NAS was derived from hospital coding P96.1, 'Neonatal withdrawal symptoms from m...

Background and objectives: Neonatal abstinence syndrome (NAS) occurs after in utero exposure to opioids, but outcomes after the postnatal period are unclear. Our objectives were to characterize childhood hospitalization after NAS. Methods: Population-based linkage study of births, hospitalization, and death records of all children registered in...

Background: The World Health Organization, governments, and communities agree that community action is likely to reduce risky alcohol consumption and harm. Despite this agreement, there is little rigorous evidence that community action is effective: of the six randomised trials of community action published to date, all were US-based and focused o...

Objective: To examine the extent to which individual- and community- level characteristics account for differences in risky alcohol consumption. Method: A cross-sectional postal survey of 2,977 randomly selected individuals from 20 regional communities in NSW, Australia. Individuals drinking at harmful levels on the AUDIT and for risk of harm in...

Introduction and AimsThis study aimed to estimate the prevalence and describe the patterns of alcohol use during pregnancy among Australian mothers. The study also aimed to examine the characteristics associated with alcohol use in pregnancy. Design and Methods Data comprised two representative samples of families (infant cohort=5107 parents of 0-...

Issues: Alcohol exposure in utero is associated with a range of adverse outcomes in pregnancy and can cause long-term disability. Fetal alcohol spectrum disorder (FASD) is an umbrella term to describe a range of effects from prenatal alcohol exposure including fetal alcohol syndrome (FAS). Determining the prevalence of FASD is challenging. Approa...

Given limited research evidence for community-based alcohol interventions, this study examines the intervention preferences of rural communities and alcohol professionals, and factors that influence their choices. Community preferences were identified by a survey of randomly selected individuals across 20 regional Australian communities. The prefer...

To date, no studies have adequately examined whether community-level, rather than individual-level, characteristics, are associated with high rates of alcohol-related traffic crashes (ARTC). This study aims to identify a proxy measure of ARTC most appropriate to rural communities in New South Wales (NSW), Australia, and to identify community charac...

Alcohol-related crime is a substantial community problem. There is evidence to suggest that certain geographic areas experience higher rates of alcohol-related crime and that both individual and community factors are associated with alcohol-related crime. There is limited research at the community level despite communities being the target of inter...

Recent attempts to reduce alcohol-related harms have focused on strategically mobilizing and co-ordinating resources at the community level, to complement attempts to modify individuals' behaviours (Holder, 2000; Holder et al ., 2000; Giesbrecht, 2007; Stafstrom and Larsson, 2007; Wallin, 2007). This has prompted the development of evaluation desig...

Aim: A whole-of-community approach can be defined as a range of intervention strategies simultaneously implemented across a whole community. One possibility for the lack of evidence for the effectiveness of this type of approach to reducing alcohol-related harm is that whole-of-community strategies to date have not examined whether this type of app...

This study examines the effectiveness and costs of follow-up phone calls in improving response rates to a community survey. Non-responders to a postal survey were randomly allocated to receive a phone call or no phone call. The resources used for the development and implementation of the survey were documented. The response rates and cost per level...

Background: Methadone maintenance was the first widely used opioid replacement therapy to treat heroin dependence, and it remains the best-researched treatment for this problem. Despite the widespread use of methadone in maintenance treatment for opioid dependence in many countries, it is a controversial treatment whose effectiveness has been disp...

Background: Buprenorphine maintenance treatment has been evaluated in randomised controlled trials against placebo medication, and separately as an alternative to methadone for management of opioid dependence. Objectives: To evaluate buprenorphine maintenance compared to placebo and to methadone maintenance in the management of opioid dependence...

Objectives: To assess the health status of heroin users starting and following 3 months of pharmacotherapy for opioid dependence, and to compare outcomes to a range of other chronic medical illnesses treated with maintenance medication. Methods: The study uses pooled data from 6 clinical trials included in an Australian National Evaluation of Pharm...

This paper examines population trends in morphine prescriptions in Australia, and contrasts them with findings from annual surveys with regular injecting drug users (IDU). Data on morphine prescriptions from 1995 to 2003 were obtained from the Drug Monitoring System (DRUMS) run by the Australian Government Department of Health and Ageing. Data coll...

We examine alcohol use in conjunction with ecstasy use and risk-taking behaviors among regular ecstasy users in every capital city in Australia. Data on drug use and risks were collected in 2004 from a national sample of 852 regular ecstasy users (persons who had used ecstasy at least monthly in the preceding 6 months). Users were grouped according...

A cross-sectional survey of 372 regular ecstasy users was conducted to examine the benefits and risks perceived to be associated with the use of party drugs. A wide range of benefits and risks were reported across six drug types with some considered drug-specific. Commonly perceived risks included physical and psychological harms that were consiste...

Previous research has found that female injecting drug users (IDU) are younger and more likely to be involved in risky behaviours such as needle sharing and sex work than male IDU. Aboriginal female drug users, in particular, are over-represented in IDU and prison populations. These factors place female IDU at increased risk of health problems and...

Background This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU) who report engaging in sex work for money or drugs and regular injecting drug users who do not. Methods Cross sectional data collected from regular IDU interviewed as part of the New South W...

This study included 380 participants in five heroin detoxification trials whose data were pooled to enable direct comparison of five detoxification methods in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD). Rapid detoxification achieved similar initial abstinence rates with either anaesthesia or sedation (aver...

To assess the effect of a restriction on publicly subsidised temazepam 10 mg capsules upon the injection of benzodiazepines by injecting drug users (IDUs). Cross-sectional study of regular IDUs targeting periods before and after the policy change. Analysis of prescription data, including time-series analysis. Drug services in the capital cities of...

The aim of this study was to examine changes in drug use patterns among groups of injecting drug users (IDU) who remained in the drug market during a period of reduced heroin availability in NSW, Australia. Cross-sectional data collected from regular IDU interviewed as part of the NSW Illicit Drug Reporting System (IDRS) between 1996-2003 were anal...

Since 1996, the Illicit Drug Reporting System (IDRS), Australia's strategic early warning system for illicit drug trends, has monitored annual trends in the markets for the four main illicit drug classes, cannabis, methamphetamine, cocaine and heroin. In 2000, a 2-year trial was implemented to examine the feasibility of using similar methodology to...

The Illicit Drug Reporting System (IDRS) is a national illicit drug monitoring system intended to serve as a strategic early warning system, identifying emerging trends of local and national concern in illicit drug markets. The IDRS consists of three components: interviews with injecting drug users (IDU); interviews with key informants (KIs), profe...

Buprenorphine is used in the treatment of opioid dependence. Due to its pharmacology, the transfer from methadone to buprenorphine may precipitate withdrawal symptoms. Methadone maintained patients with clinical indicators of stability who were seeking withdrawal from methadone were recruited from three Australian states. Patients on methadone dose...

Methadone maintenance was the first widely used form of opioid replacement therapy developed to treat heroin dependence, and it remains the best-researched treatment for this problem. Despite the widespread use of methadone in maintenance treatment for opioid dependence in many countries, it is a controversial treatment whose effectiveness has been...

The Illicit Drug Reporting System (IDRS) monitors illicit drug markets across Australia. The IDRS consists of three components: (1) interviews with injecting drug users (IDU); (2) interviews with key informants, professionals who have regular contact with illicit drug users through their work; and (3) analysis and examination of indicator data sour...

Buprenorphine has recently been reported to be an alternative to methadone and LAAM for maintenance treatment of opioid dependent individuals, differing results are reported concerning its relative effectiveness indicating the need for an integrative review. OBJECTIVES: To evaluate the effects of buprenorphine maintenance against placebo and methad...

This report provides the findings from trials of pharmacotherapies for opioid dependence. The treatment categories are methadone maintenance, buprenorphine maintenance, LAAM maintenance, naltrexone treatment, rapid opioid detoxification with anaesthesia or sedation, outpatient detoxification using buprenorphine, conventional inpatient detoxificatio...

To determine the proportion of clients engaged in methadone maintenance treatment who have favourable prognosis for withdrawal, and to examine client perceptions and expectations of withdrawal. A broad cross-section of 856 methadone clients was sampled across Melbourne, Sydney and Brisbane. Self-complete surveys were developed for the clients, thei...