Dan I Lubman

Monash University (Australia) · Turning Point

Background People in justice settings experience higher rates of psychiatric morbidity, including alcohol and drug use disorders, compared with the general population. However, our understanding of opioid-related harms in justice settings is limited. This study used ambulance data to examine opioid-related harms and experiences of care in New South...

Aims This study tested the efficacy and safety of a 12‐week course of lisdexamfetamine in reducing methamphetamine use, an outcome which is associated with improvements in health and wellbeing, in people dependent on methamphetamine. Design, setting and participants This study was a randomised double‐blind placebo‐controlled trial conducted in six...

Background: Children in out-of-home-care (OOHC) are a vulnerable population, typically with complex needs, however there is minimal research examining the behavioural presentations that lead to the increased use of acute emergency care by OOHC children. Objective: This study aimed to describe differences in lifetime complexity factors identified du...

Background Mental health presentations account for a considerable proportion of paramedic workload; however, the decision-making involved in managing these cases is poorly understood. This study aimed to explore how paramedics perceive their clinical decision-making when managing mental health presentations. Methods A qualitative descriptive study...

Introduction A disproportionate number of mental health presentations to emergency services are made by frequent presenters. No current consensus definition of a frequent presenter exists. Using a statewide population-based ambulance database, this study (i) applied previous statistical methods to determine thresholds for frequent presenters, (ii)...

Cannabis use disorder (CUD) is associated with adverse mental health effects, as well as social and cognitive impairment. Given prevalence rates of CUD are increasing, there is considerable efforts, and need, to identify prognostic markers which may aid in minimising any harm associated with this condition. Previous neuroimaging studies have reveal...

Background Methamphetamine Use Disorder (MAUD) is associated with major public heath burden worldwide, yet medication treatment options are lacking. For many patients, the first step in a treatment episode is admission to a residential detoxification or rehabilitation unit for withdrawal, however unplanned early discharge is common, and evidence su...

Introduction Inducting buprenorphine from methadone has traditionally involved initial opioid withdrawal, with risk of mental state deterioration in patients with serious mental illness (SMI). Micro‐dosing of buprenorphine, with small incremental doses, is a novel off‐label approach to transitioning from methadone and does not require a period of m...

Introduction Helplines are often the first contact with the alcohol and other drug (AOD) treatment system. We examined call data from an AOD helpline in Victoria, Australia, to explore the association between COVID‐19 lockdown measures and frequency of calls. Methods This was a retrospective analysis of AOD helpline data collected between January...

Introduction Tobacco smoking is highly prevalent among alcohol and other drugs (AOD) service clients and, despite interest in quitting, abstinence is rarely sustained. Nicotine products may assist after discharge from residential treatment services, but little is known about client receptivity to them. This study examined AOD withdrawal service cli...

Background: Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients’ experiences of depot buprenorphine and its embodied effects. This qualitative study aims to explore patients’ experiences of depot buprenorphine treatment, including how it...

Background Cannabis use disorder (CUD) is increasingly common and contributes to a range of health and social problems. Cannabidiol (CBD) is a non-intoxicating cannabinoid recognised for its anticonvulsant, anxiolytic and antipsychotic effects with no habit-forming qualities. Results from a Phase IIa randomised clinical trial suggest that treatment...

Cannabis use disorder (CUD) is associated with adverse mental health effects, as well as social and cognitive impairment. Given prevalence rates of CUD are increasing, there is considerable efforts, and need, to identify prognostic markers which may aid in minimising any harms associated with this condition. Previous neuroimaging studies have revea...

Objective Preventable transmission of blood‐borne viruses (BBV), including human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV), continue in at‐risk populations, including people who use alcohol and drugs (AODs). To our knowledge, no studies have explored the use of ambulance data for surveillance of AOD harms in...

Purpose: The purpose of this randomized controlled trial (Trial registration ID: redacted) was to examine the feasibility, acceptability, and efficacy of the Step One program, an SMS-based alcohol intervention for same-sex attracted women (SSAW). Methods: Ninety-seven SSAW who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT) we...

Background:: Cognitive disinhibition underpins alcohol and drug use problems. Although higher-risk substance use is consistently associated with poorer disinhibition, current findings may be limited by narrow recruitment methods, which over-represent individuals engaged in traditional treatment services with more severe presentations. We embedded a...

Introduction The novel coronavirus (COVID‐19) pandemic necessitated the rapid uptake of telehealth to deliver treatment for alcohol and other drug (AOD) concerns. However, little is known about how the move from in‐person to telehealth delivery impacted clients' experience of care. This qualitative study aimed to explore experiences of telehealth a...

Objective Alcohol use disorders confer a significant burden of disease and economic cost worldwide. However, the utilisation of pharmacotherapies to manage alcohol use disorder is poor. We aimed to conduct a systematic review of economic evaluation studies of alcohol use disorder pharmacotherapies. Methods A search was conducted in Embase, Medline...

Background and aims: Public health measures introduced to contain the spread of the SARS-CoV-2 virus likely affected opioid supply and demand, as well as the patterns and contexts of opioid use. We measured opioid-related harms during the first 2 years of COVID-19 restrictions in Victoria, Australia. Design: We adopted an interrupted time series...

Introduction Prescription drug monitoring programs (PDMP) are increasingly used to identify people prescribed high‐dose opioids. However, little is known about whether PDMPs impact opioid agonist treatment (OAT) uptake, the gold standard for opioid use disorder. This study examined the impact of PDMP implementation on OAT initiation among people pr...

UNSTRUCTURED Introduction Increasing harms related to prescription opioids over the past decade has led to the introduction of a range of key national and state policy initiatives across Australia. However, similar opioid policies internationally have had mixed outcomes, including unintended adverse consequences. There is little real-world evidence...

Background Increasing harms related to prescription opioids over the past decade have led to the introduction of a range of key national and state policy initiatives across Australia. These include introducing a mandatory real-time prescription drug–monitoring program in the state of Victoria from April 2020 and a series of changes to subsidies for...

Introduction: Engaging people with lived experience of alcohol and other drug use as peer researchers in qualitative research is becoming more common. However, there are differing opinions on how to best engage and support peer researchers. Case presentation: Through this case study the researchers aimed to illustrate the potential benefits of a...

Introduction Truck driving is one of the most common male occupations worldwide. Drivers endure long working hours, isolation, separation from family, compromised sleep, and face rigid regulatory requirements. Studies have documented the work factors contributing to poor health outcomes, however these have not been explored in the Australian contex...

This study reports outcomes from a preliminary study of an online, peer-led support group intervention for family members of people experiencing addiction. A mixed-methods design, comprising within-subjects analysis of intervention data and semi-structured interviews, was used. Seventy-eight participants received the intervention. Participants comp...

Objectives: To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening. Design: Single-site, double-blinded randomised controlled trial. Setting: Maroondah BreastScreen (Ea...

Background: Australian prescription drug monitoring programs (PDMPs) provide information about a patient's recent medication history for controlled drugs at the point of prescribing and dispensing. Despite their increasing use, the evidence for PDMPs is mixed, and is almost exclusively from the United States. This study examined the impact of PDMP...

Aims: To determine whether the risk of psychotic symptoms during weeks of methamphetamine use was dependent on, increased by, or independent of having a family history of psychosis. Design: Secondary analysis of 13 contiguous 1-week periods of data (1370 weeks). A risk modification framework was used to test each scenario. Setting: Geelong, Wo...

As the name ‘talk therapy’ suggests, a key aim of alcohol and other drug counselling, psychotherapy and other talk therapies is to discuss issues, concerns and feelings with a health professional. Implicit here is the therapeutic value of talking through issues with a trained professional. But as with all interactions, therapeutic encounters involv...

Purpose The OPPICO cohort is a population-based cohort based on non-identifiable electronic health records routinely collected from 464 general practices in Victoria, Australia, created with the aim of understanding opioid prescribing, policy impacts and clinical outcomes. The aim of this paper is to provide a profile of the study cohort by summari...

Alcohol harms are often determined using a proxy measure based on temporal patterns during the week when harms are most likely to occur. This study utilised coded Australian ambulance data from the Victorian arm of the National Ambulance Surveillance System (NASS) to investigate temporal patterns across the week for alcohol-related ambulance attend...

Background and aims: Alcohol is a major modifiable risk factor for female breast cancer, with breast cancer risk now associated with substantially lower consumption levels than those previously deemed safe. This study sought to measure risky drinking among women attending breast screening services in Australia according to new national alcohol gui...

Background Australia has one of the highest rates of methamphetamine (MA) use in the world; however, uptake of in-person psychological treatment remains extremely low due to numerous individual (e.g. stigma, shame) and structural (e.g. service accessibility, geographical location) barriers to accessing care. Telephone-delivered interventions are id...

Family members of people experiencing addiction may experience increased stress and have difficulty coping with disrupted relationships, stigma, and isolation. Education programs for affected family members aim to assist in improving coping skills, understanding of addiction, and provide support, yet these have not been subjected to in-depth resear...

Background: Deficits in executive function are common in methamphetamine use disorder (MUD), likely contributing to difficulties in sustained treatment success. Cognitive remediation interventions are designed to treat such deficits but have not been adapted to the needs of people with MUD. This study presents a proof-of-concept trial to evaluate...

Purpose Integrated care is widely supported as a means of improving treatment outcomes for people with co-occurring mental health and substance use disorders. Over the past two decades, Australian state and federal governments have identified integrated care as a policy priority and invested in a number of research and capacity building initiatives...

Background Australia has one of the highest rates of methamphetamine (MA) use in the world; however, uptake of in-person psychological treatment remains extremely low due to numerous individual (e.g., stigma, shame) and structural (e.g., service accessibility, geographical location) barriers to accessing care. Telephone-delivered interventions are...

Background: Gamma-hydroxybutyrate (GHB) use and attributable harms have been increasing in Australia, however changes over time, including the impact of COVID-19 lockdowns and restrictions on harms requiring an ambulance attendance, are unknown. This study utilised a novel population-based surveillance system to identify the types of GHB-related h...

Background: Alcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumptio...

BACKGROUND Alcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumption....

Opioid harm can vary by opioid type. This observational study examined the effect of opioid type (oxycodone vs. tapentadol) on rates of persistent postoperative opioid use (‘persistence’). We linked hospital and community pharmacy data for surgical patients who were dispensed discharge opioids between 1 January 2016 and 30 September 2021. Patients...

Aims Despite the magnitude of alcohol use problems globally, treatment uptake remains low. This study sought to determine the proportion of people presenting to telephone-delivered alcohol treatment who are first-time help-seekers, and explored perceived barriers to help-seeking to understand the barriers this format of treatment may help to addres...

Aims: Treatment of methamphetamine dependence requires monitoring of recent use or abstinence. Self-report is commonly used for routine monitoring, but the accuracy of self-report is not established. For the treating clinician, the key accuracy statistic is the negative predictive value (NPV). The study aim was to estimate the NPV of self-reported...

Introduction: There are a range of models and structures that determine features of alcohol and other drug treatment. Despite some structures being long-established, less is known about how specific aspects of service delivery impact treatment-seeking for people who use alcohol and other drugs. This Australian qualitative study explored both peopl...

Importance: Despite the magnitude of alcohol use problems globally, treatment uptake remains low. Telephone-delivered interventions have potential to overcome many structural and individual barriers to help seeking, yet their effectiveness as a stand-alone treatment for problem alcohol use has not been established. Objective: To examine the effe...

Background Approach bias modification (ApBM) for alcohol use disorder helps prevent relapse, yet the psychological mechanisms underlying its efficacy remain unclear. Alcohol craving predicts relapse and appears to be related to the biased processing of alcohol stimuli which is reduced by ApBM. However, there is little research examining whether ApB...

Background: Pharmacological interventions for disordered and problem gambling have been employed in clinical practice. Despite the availability of several reviews of the efficacy of pharmacological interventions for disordered or problem gambling, few have employed systematic search strategies or compared different categories of pharmacological in...

MADDERN, X.J. et al., Enhancing the clinical efficacy of cognitive and psychological approaches to treat substance use disorders through mechanism-guided interventions. NEUROSCI BIOBEHAV REV.(.) XXX-XXX, 2022. - Despite decades of research in the field of addiction, relapse rates for substance use disorders remain high. Consequently, there has been...

Objective: Amphetamine-type stimulants are increasingly implicated in road trauma incidents. Although ambulances are typically first to attend these emergencies, limited research has used paramedic clinical data to examine the contribution of amphetamine use to road trauma-related ambulance attendances. We describe the clinical and temporal risk p...

Background Methamphetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes. However, current treatments for MUD do not directly address cognition. We recently modified Goal Management Training (now Goal Management Training⁺; GMT⁺), a group-based intervention originally designed to improv...

We introduce a novel method to estimate the causal effects of an intervention over multiple treated units by combining the techniques of probabilistic forecasting with global forecasting methods using deep learning (DL) models. Considering the counterfactual and synthetic approach for policy evaluation, we recast the causal effect estimation proble...

Background and aims: Approach bias modification (ApBM) targeting alcohol approach bias has been previously shown to reduce likelihood of relapse during the first 2 weeks following inpatient withdrawal treatment (IWT). We tested whether ApBM's effects endure for a longer period by analysing alcohol use outcomes 3, 6, and 12 months post-discharge....

Brief and low intensity (LI) interventions are a relatively new approach to delivering evidence-based psychological treatments for adults presenting with common mental health problems, and an even newer approach for working with children and young people. Over recent years, empirically validated brief and LI psychological treatments for children an...

Brief and low intensity (LI) interventions are a relatively new approach to delivering evidence-based psychological treatments for adults presenting with common mental health problems, and an even newer approach for working with children and young people. Over recent years, empirically validated brief and LI psychological treatments for children an...

Objective This study aimed to examine the environmental and operational factors that disrupt sleep in the acute, non-ICU hospital setting.Design, setting and participantsThis was a prospective study of adult patients admitted to an acute tertiary hospital ward (shared versus single room) and sleep laboratory (single room conducive to sleep).Main ou...

Background Tobacco smoking rates in alcohol and other drug (AOD) treatment settings is much higher than in the general Australian population. As a result, people seeking treatment for AOD use experience a greater tobacco-related burden of illness. Attempts to reduce smoking rates in AOD treatment consumers have failed to identify smoking cessation...

Background Methamphetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes including earlier drop out and relapse. However, current treatments for MUD do not address executive functions. Goal Management Training (GMT) is an evidence-based cognitive remediation program for executive dysfu...

Background: The presence of discrete but fluctuating precipitants, in combination with the dynamic nature of gambling episodes, calls for the development of tailored interventions delivered in real time, such as just-in-time adaptive interventions (JITAIs). JITAIs leverage mobile and wireless technologies to address dynamically changing individual...

BACKGROUND People with gambling problems frequently report repeated unsuccessful attempts to change behaviour. Even though a range of behaviour change techniques are available to individuals to reduce gambling harm, they can be challenging to implement or maintain in the moment. The provision of implementation support, tailored for immediate, real-...

Background: People with gambling problems frequently report repeated unsuccessful attempts to change their behavior. Although many behavior change techniques are available to individuals to reduce gambling harm, they can be challenging to implement or maintain. The provision of implementation support tailored for immediate, real-time, individualiz...

Introduction Each year, an estimated two million Australians commence opioids, with 50 000 developing longer-term (persistent) opioid use. An estimated 3%–10% of opioid-naïve patients prescribed opioids following surgery develop persistent opioid use. This study will compare rates of persistent opioid use between two commonly used postoperative opi...

Background: The negative health consequences of truck driving are well documented. However, despite the distinct occupational challenges between long- and short-haul driving, limited research has been conducted on how the health profile of these drivers differ. The aims of this study were to characterise the physical and mental health of Australia...

Although previous research in alcohol dependent populations identified alterations within local structures of the addiction 'reward' circuitry, there is limited research into global features of this network, especially in early recovery. Transcranial magnetic stimulation (TMS) is capable of non-invasively perturbing the brain network while electroe...

Introduction People are increasingly turning to online services for help with substance use concerns. There has, however, been limited research on the use of online substance use services by regional and rural populations. This study explored: (1) the experiences of care of regional and rural clients of an Australian national online text-based subs...

Telephone-delivered interventions for mild-to-moderate alcohol problems are becoming increasingly available. This study explored experiences of Ready2Change (R2C), a multiple-session outbound telephone-delivered psychological intervention for mild-to-moderate alcohol use disorder, to inform treatment uptake and scalability strategies. Semi-structur...

Ali Cheetham,1,2 Louisa Picco,1 Anthony Barnett,1,2 Dan I Lubman,1,2 Suzanne Nielsen1,2 1Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia; 2Turning Point, Eastern Health, Richmond, Victoria, 3121, AustraliaCorrespondence: Suzanne NielsenMonash Addiction Resear...

Opioid use disorder (OUD) has been linked to exaggerated attentional, affective, and arousal responses to opioid-related stimuli, as well as altered responses to other affective (eg, naturally rewarding or aversive) stimuli, particularly blunted responses to pleasant/rewarding stimuli. Both exaggerated responses to drug-related stimuli and reduced...

Purposes Timely delivery of treatment and rehabilitation is generally acknowledged to support injury recovery. This study aimed to describe the timing of health service use by injured truck drivers with work-related injury and to explore the association between demographic and injury factors and the duration of health service use. Methods Retrospec...

Introduction The Australian guidelines to reduce health risks from drinking alcohol were released in 2020 by the National Health and Medical Research Council. Based on the latest evidence, the guidelines provide advice on how to keep the risk of harm from alcohol low. They refer to an Australian standard drink (10 g ethanol). Recommendations • •...