Katherine M Conigrave

Katherine M Conigrave
Royal Prince Alfred Hospital | RPA · Drug Health Service

FAChAM, FAFPHM, PhD, MB BS (Hons 1)

About

223
Publications
22,358
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Introduction
Kate Conigrave is an addiction medicine physician and public health physician at Royal Prince Alfred Hospital, Sydney. She is also a conjoint Professor at the University of Sydney. Kate is joint Director of the Centre of Research Excellence: Indigenous Health and Alcohol, funded by the National Health and Medical Research Council of Australia. She chaired the committee which reviewed Australia's drinking guidelines (released 2020).
Additional affiliations
January 2012 - present
The University of Sydney
Position
  • Professor (Conjoint)

Publications

Publications (223)
Article
Full-text available
Background We have previously shown that service-wide support can increase the odds of alcohol screening in any 2-month period in a cluster randomized trial of service-wide support to Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHS). Here we report an exploratory analysis on whether the resulting pattern of screeni...
Article
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Background Disadvantage and transgenerational trauma contribute to Aboriginal and Torres Strait Islander (Indigenous) Australians being more likely to experience adverse health consequences from alcohol and other drug use than non-Indigenous peoples. Addressing these health inequities requires local monitoring of alcohol and other drug use. While c...
Article
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Background Aboriginal and Torres Strait Islander (‘Indigenous’) Australians experience a greater burden of disease from alcohol consumption than non-Indigenous peoples. Brief interventions can help people reduce their consumption, but people drinking at risky levels must first be detected. Valid screening tools (e.g., AUDIT-C) can help clinicians i...
Article
Several initiatives have sought to increase the number of First Nations individuals with a higher degree in research (i.e., PhD or research masters)—in Australia and in similarly colonised countries. However, little has been written on day‐to‐day support structures and mechanisms that might help First Nations Australian candidates thrive in postgra...
Article
Research into opportunities for prevention including health promotion information about alcohol and other drugs (AoD) harms for people who go to prison is sparce. This is despite there being ample research reporting how much and how frequently AoD have been used by people who go to prison. This paper describes results from a qualitative thematic an...
Article
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Introduction: First Nations people who use methamphetamine are overrepresented in regional and remote Australia and more likely to turn to family for support. This can place strain on families. The support needs of family members of individuals using methamphetamine are poorly understood. Methods: We conducted 19 focus groups and seven interview...
Article
Introduction Young people in Iraq are exposed to conflict and trauma, and to alcohol references in uncensored international TV and media. Previous regional reviews indicate that alcohol is the least studied substance in Arab countries and no data on young people in Iraq were identified. Accordingly, we re-examined the scope of available literature...
Article
The Australian Government will set the direction for addressing road safety over the next decade with its 2021–2030 National Road Safety Strategy. This road map will detail objectives and goals agreed upon by all Australian states and territories. Similar to previous national strategies, Aboriginal and Torres Strait Islander (Indigenous) Australian...
Article
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Background Mutual support groups are a popular treatment for substance use and other addictive behaviours. However, little is known about the cultural utility of these programmes for Indigenous peoples. Methods A three-round Delphi study, utilising Indigenous research yarning methods was conducted to: (1) Obtain expert opinion regarding the cultur...
Article
Full-text available
Background Unhealthy alcohol use is a key concern for Aboriginal and Torres Strait Islander (‘Indigenous Australian’) communities. Due to systematic disadvantage and inter-generational trauma, Indigenous Australians may be less likely to have satisfied basic psychological needs (autonomy, competence, and relatedness). When people are need-thwarted,...
Article
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Background Few studies have examined links between current alcohol dependence and specific harms among Indigenous Australians. We investigated these associations as well as help seeking for drinking, awareness of local treatments and recommendations to help family or friends cut down or stop drinking in two Indigenous communities. Methods A repres...
Article
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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 • •...
Article
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Introduction Aboriginal and Torres Strait Islander (Indigenous) Australians have identified alcohol consumption as an area of concern. Accurate screening tools are required to help detect and assist at-risk drinkers, and to provide accurate data to policy makers. The Finnish method (determining drinking patterns based on the last two to four drinki...
Article
Introduction: Aboriginal clients accessing Aboriginal community-controlled residential alcohol and other drug rehabilitation services in New South Wales, Australia believe they have better outcomes due to culturally appropriate care. However, there is a paucity of published treatment outcome data. This study aims to identify predictors of treatmen...
Article
Summary of recommendations and levels of evidence Chapter 2: Screening and assessment for unhealthy alcohol use Screening • Screening for unhealthy alcohol use and appropriate interventions should be implemented in general practice (Level A), hospitals (Level B), emergency departments and community health and welfare settings (Level C). • Quantit...
Article
Full-text available
Background and aims There is a higher prevalence of unhealthy alcohol use among Indigenous populations, but there have been few studies of the effectiveness of screening and treatment in primary health care. Over 24 months, we tested whether a model of service-wide support could increase screening and any alcohol treatment. Design Cluster randomiz...
Article
Purpose: The purpose of this study is to describe what a sample of men in prison believe works well for the delivery of prison-based group alcohol and other drug (AoD) treatment programs. The authors hope the findings will help inform future practise in AoD program delivery in prison. Design/methodology/approach: A qualitative research paper rep...
Article
Introduction In response to a high burden of opioid use disorder (OUD), Iran established a network of opioid agonist treatment (OAT) centres beginning in 2002. To increase treatment diversity, particularly for patients who use opium as their drug of choice, opium tincture (OT)-assisted treatment was introduced to the network. This study aimed to ex...
Article
In Australia, Aboriginal and Torres Strait Islander community controlled health services have been established since 1971 to provide accessible, quality and culturally-appropriate primary healthcare. The first of these services, the Aboriginal Medical Service Cooperative Redfern ('the AMS'), created its own Drug and Alcohol Unit ('the Unit') in 199...
Article
Introduction Measuring self-reported alcohol use is challenging in any population, including when episodic drinking may be common. Drinking among Indigenous Australians has been shown to vary greatly within and between communities. However, most survey methods assume ‘regular’ patterns of drinking. National estimates have also been shown to underes...
Article
Introduction: Little is known about the prevalence of current alcohol dependence in Indigenous Australian communities. Here we identify the frequency of reported symptoms, estimate the prevalence and describe the correlates of current alcohol dependence. Methods: A representative sample of Indigenous Australians (16+ years) was recruited from an...
Article
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COVID-19 poses grave challenges for mass gatherings. One of the world’s largest annual gatherings, Arbaeen, occurs in Iraq. We studied respiratory symptoms and risk and protective factors using representative sampling of Arbaeen pilgrims in 2019 to inform prevention of COVID-19 transmission. Structured sampling was used to recruit walking pilgrims....
Article
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Introduction SMART Recovery is a popular mutual support group program. Little is known about its suitability or perceived helpfulness for Indigenous peoples. This study explored the cultural utility of SMART Recovery in an Australian Aboriginal context. Methods An Indigenous‐lensed, multi‐methods, exploratory study design was used to develop initi...
Article
Background and aims: Unhealthy alcohol consumption is a key concern for Aboriginal and Torres Strait Islander ('Indigenous') communities. It is important to identify and treat at-risk drinkers, to prevent harms to physical or social wellbeing. We aimed to test whether training and support for Aboriginal Community Controlled Health Service (ACCHS)...
Article
Full-text available
Background: Mutual support groups are a popular treatment for substance use and other addictive behaviours. However, little is known about the cultural utility of these programmes for Indigenous peoples. Methods: A three-round Delphi study, utilising Indigenous research yarning methods was conducted to: (1) Obtain expert opinion regarding the cultu...
Article
Full-text available
A context-specific quantity-frequency (CSQF) questionnaire has been developed to accurately measure alcohol consumption using probing questions on drinking context. The study aimed to describe the drinking context associated with different drinking intensities in a community of southern Thailand using the CSQF. A cross-sectional survey was conducte...
Article
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Background: Aboriginal alcohol and other drug residential rehabilitation (residential rehabilitation) services have been providing treatment in Australia of over 50 years. However, there are no studies in Australia or internationally that document characteristics of clients attending Indigenous residential rehabilitation services worldwide. This i...
Article
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Background: First Nations peoples of Australia, New Zealand, the United States of America (USA) and Canada are more likely to be non-drinkers than other people in these countries. However, those who do drink may be at greater risk of alcohol-related harms (at a population level) due to the ongoing impacts from colonisation and associated oppressio...
Article
Background and Aims There is a need for more evidence to guide efforts to address harmful methamphetamine use amongst young Aboriginal and Torres Strait Islander Australians. ‘Communities that Care’ (CTC) is an evidence-based process developed to prevent alcohol and other drug-related harm but its suitability for use in Aboriginal contexts has not...
Article
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Background: Alcohol affects Indigenous communities globally that have been colonised. These effects are physical, psychological, financial and cultural. This systematic review aims to describe the prevalence of current (12-month) alcohol dependence in Indigenous Peoples in Australia, New Zealand, Canada and the United States of America, to identif...
Article
Introduction Aboriginal and Torres Strait Islander people are vastly over‐represented in Australian prisons. Many people in prison attribute in some way their offences to alcohol and/or other drug (AOD) use. This paper aims to understand AOD use before first and between terms in prison, among a group of Aboriginal men enrolled in a prison‐based AOD...
Article
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Background: Population estimates of alcohol consumption vary widely among samples of Aboriginal and Torres Strait Islander (Indigenous) Australians. Some of this difference may relate to non-representative sampling. In some communities, household surveys are not appropriate and phone surveys not feasible. Here we describe activities undertaken to...
Article
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Introduction and Aims There is a need for detailed information on methamphetamine use in Aboriginal and Torres Strait Islander communities. We describe a national survey on methamphetamine use among Aboriginal and Torres Strait Islander people and non‐Indigenous people. Design and Methods Participants aged 16 years or older who reported using meth...
Article
Little is known about the significance of cultural differences to how caregivers receive a diagnosis of neurodevelopmental disability. As part of a Fetal Alcohol Spectrum Disorder prevalence study among sentenced, detained youth, our qualitative study explored the experiences of diagnostic assessment among detained young people and their caregivers...
Article
Background Alcohol is a leading risk factor for death and disability globally. Due to the Islamic prohibition of alcohol consumption, alcohol policy is an under-studied and sensitive topic in Muslim majority countries (MMCs). In addition, drinkers in these countries may face barriers to treatment access due to stigma or the legal status of alcohol....
Article
Background and aims: To reduce health and social inequities, it is important to understand how drinking patterns vary within and between Indigenous peoples. We aimed to assess variability in estimates of Indigenous Australian drinking patterns and to identify demographic and methodological factors associated with this. Design: A three-level meta...
Article
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Background: Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. The Continuing Quality Improv...
Article
Background: Arbaeen is an annual religious procession in Iraq with an estimated 17-20 million participants. Public health risks associated with such a mass gathering can be serious at both local and global levels. This is the first quantitative examination of risk factors for, and symptoms of, infectious disease among Arbaeen participants. Method...
Article
Full-text available
Background Alcohol consumption among Indigenous Australians can be irregular, depending on social and geographic context. The Finnish method uses the last four drinking occasions to estimate drinking quantity and pattern. The Grog Survey App is an interactive and visual tablet computer application which uses touch-screen technology to deliver quest...
Article
Full-text available
Introduction Indigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioec...
Article
An understanding of alcohol’s place in Iraq’s history and society can help inform alcohol policy responses in that country and other Muslim majority countries. This article describes the history of alcohol in Iraq from ancient to modern times, with reflection on the challenges facing Iraqi youth today. A search was undertaken to identify peer-revie...
Article
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Background: The Grog Survey App is a visual and interactive tablet computer-based survey application. It has been shown to be an accurate and acceptable tool to help Indigenous Australians describe what they drink. Methods: The Grog Survey App was used to enquire into patterns of drinking in a stratified sample of Indigenous Australians in urban...
Article
Full-text available
Background: Methamphetamine use is of deep concern to Aboriginal and Torres Strait Islander communities, but access to culturally appropriate treatment resources and services is limited. Web-based programs have potential as flexible and cost-effective additions to the range of treatment options available to Aboriginal people. The We Can Do This on...
Article
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Background: Alcohol consumption among Indigenous Australians can involve a stop-start pattern of drinking, with consumption well above recommended guidelines on each occasion. Such intermittent drinking patterns can make screening for risky drinking difficult. This study evaluates the ability of several short alcohol screening tools, contained in...
Article
Introduction and aims: Substance use significantly contributes to increasing the disease burden experienced by young Aboriginal and Torres Strait Islander (Aboriginal) Australians. Little is known about the primary healthcare needs of young Aboriginal people who use drugs. The aim of this study was to pilot Audio Computer Assisted Self-Interviewin...
Article
Background: Muslim majority countries (MMCs) typically have limited alcohol policy development due to Islamic prohibition of alcohol consumption. In response to recent increases in alcohol consumption and related harms, MMCs have introduced civil alcohol policies, ranging from total prohibition to European-style regulations. Using Iran as a case s...
Preprint
Full-text available
BACKGROUND Methamphetamine use is of deep concern to Aboriginal and Torres Strait Islander communities, but access to culturally appropriate treatment resources and services is limited. Web-based programs have potential as flexible and cost-effective additions to the range of treatment options available to Aboriginal people. The We Can Do This web-...
Article
We examined acceptability and feasibility of a tablet application (“App”) to record self-reported alcohol consumption among Aboriginal and Torres Strait Islander Australians. Four communities (1 urban; 3 regional/remote) tested the App, with 246 adult participants (132 males, 114 females). The App collected (a) completion time; (b) participant feed...
Article
One in 25 adults in Australia becomes dependent on alcohol at some stage. GPs play a key role in earlier detection of alcohol dependence and can provide treatment for withdrawal (where safe to do so), relapse-prevention medicines and support.
Article
Aboriginal and Torres Strait Islander (Indigenous) health professionals working in the alcohol and other drugs field perform a complex role in tackling substance misuse and related harms. Professional training and development opportunities for these “frontline” Indigenous alcohol and other drugs staff is key to prevent burnout and to allow them to...
Article
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After publication of the original article [1] it was noted that the name of author, Peter Jack, was erroneously typeset in both the PDF and online formats of the manuscript as Peter Jack GradDipIndigH.
Article
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Introduction and aims Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHSs) around Australia have been asked to standardise screening for unhealthy drinking. Accordingly, screening with the 3-item AUDIT-C (Alcohol Use Disorders Identification Test—Consumption) tool has become a national key performance indicator. Here...
Article
Full-text available
Background The challenges of assessing alcohol consumption can be greater in Indigenous communities where there may be culturally distinct approaches to communication, sharing of drinking containers and episodic patterns of drinking. This paper discusses the processes used to develop a tablet computer-based application (‘App’) to collect a detailed...
Article
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p>Introduction: Indigenous Peoples who have been colonized face a higher burden of harm from alcohol and increased risk of alcohol use disorders. Yet they often also have limited access to alcohol treatment. Limited access to withdrawal management (“detox” in particular) can be a barrier to recovery. Ambulatory or “outpatient” alcohol detox can off...
Chapter
Despite substantial adverse effects from benzodiazepine use, these medicines are frequently prescribed and dispensed. This chapter describes the dependence and misuse potential of benzodiazepines and the role of health care professionals in therapeutic care mainly through appropriate prescribing and dispensing. All regions of the world have reporte...
Article
Full-text available
Background Socially disadvantaged groups, such as Aboriginal Australians, tend to have a high prevalence of multiple lifestyle risk factors, increasing the risk of disease and underscoring the need for services to address multiple health behaviours. The aims of this study were to explore, among a socially disadvantaged group of people attending an...
Article
Full-text available
Aboriginal women with substance use disorders are a vulnerable population. This study examines approaches used to deliver support to Aboriginal women in an outpatient alcohol and other drug treatment service in Australia. A descriptive qualitative study was undertaken using structured interviews to explore staff and client perceptions of current an...
Article
The tragic deaths of two young men after unprovoked violent assaults in Kings Cross, Sydney between 2012 and 2014 prompted a public outcry. This added to existing voices of health, police and resident bodies who were calling for measures to reduce alcohol-fuelled violence. As a result, the New South Wales Government amended the Liquor Act 2007 (NSW...
Article
Commentary to: Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization
Article
Background: There is a pressing need to improve alcohol treatment services for Aboriginal and Torre Strait Islander peoples with alcohol dependence. One component of treatment is the use of medicines including naltrexone and acamprosate. Access to these medicines among the general drinking population is poor and, anecdotally, even worse for Aborig...
Article
Background and aims: Many policies have been introduced to reduce alcohol harm in different countries. However, Muslim majority countries (MMCs), where the major religion (Islam) prohibits alcohol consumption, have less well-developed civil alcohol policies. Overall, MMCs have low prevalence of alcohol consumption, although recently most MMCs have...
Article
Alcohol-related harms cause great concern to Aboriginal and Torres Strait Islander (Indigenous) communities in Australia as well as challenges to policy makers. Treatment of alcohol use disorders forms one component of an effective public health response. While alcohol dependence typically behaves as a chronic relapsing condition, treatment has bee...
Article
Anecdotal reports have linked cannabis use to violence in some remote Australian Aboriginal communities. We examine the relationship between cannabis use and presentations to local clinics for violence-related trauma at a population level. As part of a larger study, estimates of cannabis and alcohol use status were obtained for 264 randomly selecte...
Article
Due to the difficulty encountered in disseminating resource-intensive emergency department (ED)-based brief alcohol interventions into real-world settings, this study evaluated the effect of a mailed personalized feedback intervention for problem drinking ED patients. At 6-week follow-up, this intervention was associated with a statistically signif...
Article
Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. METHODs to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aborig...