Nicole Kathleen Lee

Curtin University · National Drug Research Institute (NDRI)

Background Drug alerts designed for health and community workforces have potential to avert acute harms associated with unpredictable illicit drug markets, by preparing workers to respond to unusual drug-related events, and distribute information to service users. However, the design of such alerts is complicated by diverse needs of individuals, an...

Background Drug alerts designed for health workforces have potential to avert the acute harms associated with unpredictable illicit drug markets, by preparing workers to respond to unusual drug-related events and distribute information to service users. However, the design of such alerts is complicated by the socio-political contexts in which they...

Background Alerts about drug market changes (e.g., drug strength, purity, adulterations, or other trends) may be useful to assist health and community workers to anticipate, prevent and respond to unexpected adverse drug events. This study aimed to establish factors influencing the successful design and implementation of drug alerts for use in clin...

Introduction: Internationally, clinical/practice supervision is considered essential in the development and maintenance of professional proficiency across health disciplines. Among alcohol and other drug (AOD) workers, however, access to effective clinical supervision is limited. This study examined perceived barriers and facilitators to: (i) AOD...

Cognitive behavioural therapy is an umbrella term that describes an expansive group of therapies. Although many in number and broad in their approach, they have in common a focus on ‘cognitions’ (including thoughts, beliefs, schemas and metacognitions) as the central driver of, and the solution to, effective emotion regulation. The early cognitive...

Zusammenfassung Einleitung Methamphetaminkonsum hat sich im Südosten Deutschlands zu einer flächendeckenden Problematik ausgeweitet. Gleichzeitig fehlen deutschsprachige, standardisierte Therapiemanuale in der Versorgungslandschaft. Methodik Evaluation von Prozessvariablen eines neuen Manuals für die qualifizierte Entgiftungs- und Motivationsbehand...

Background: Regular methamphetamine use is associated with increased rates of psychiatric symptoms. Although there has been a substantial body of research reporting on the effectiveness of psychological treatments for reducing methamphetamine use, there is a paucity of research examining the effects of these treatments on co-occurring psychiatric...

Background: Given the high frequency and significance of anxiety and depression following traumatic brain injury (TBI), there is a need to evaluate the efficacy of psychological interventions and to understand factors influencing response to such interventions. The present study investigated factors associated with positive response to cognitive b...

Background: Demand for treatment for amphetamine use is increasing internationally. Establishing effective pharmacotherapy provides broader treatment options for people who are dependent on amphetamine and may encourage engagement in evidence-based behavioral treatment. This study aimed to identify medicines that have potential in improving treatm...

Background: There is increasing recognition that the workplace holds potential as an alcohol prevention/intervention setting. However, few robust studies of workplace interventions have been conducted. Research to-date has yielded mixed results. The current study aimed to address this knowledge gap by undertaking a process evaluation of the Workpla...

Introduction and aims: The workplace holds substantial potential as an alcohol harm reduction and prevention setting. Few studies have rigorously examined strategies to reduce workplace alcohol-related harm. Hence, an in-situ 3 year trial of a comprehensive alcohol harm reduction intervention in Australian manufacturing workplaces was undertaken....

Introduction People who use methamphetamine (MA) regularly, often experience symptoms of mental ill health associated with the use of the drug. These include symptoms of psychosis, depression, anxiety and also cognitive deficits. Accordingly, psychological treatments aim to reduce MA use and related problems, including symptoms of mental ill health...

Introduction and aims: We previously found that residential rehabilitation increased continuous abstinence from methamphetamine use 1 year after treatment. We examine what client and treatment characteristics predict this outcome. Design and methods: Participants (n = 176) were dependent on methamphetamine and entering residential rehabilitation...

Aim and background: We estimated health service utilisation attributable to methamphetamine use, its national impact and examined other predictors of health service utilisation among dependent methamphetamine users. Method: Past year rates of health service utilisation (number of attendances for general hospitals, psychiatric hospitals, emergenc...

https://theconversation.com/viewpoints-is-addiction-a-disease-63113

Among men, depression is often unrecognised and untreated. Men employed in male-dominated industries and occupations may be particularly vulnerable. However, efforts to develop tailored workplace interventions are hampered by lack of prevalence data. A systematic review of studies reporting prevalence rates for depression in male dominated workforc...

Background Considerable attention has been focused on the impact of young people’s alcohol use. To address this, schools often implement alcohol and drug education and there are many potential programmes to choose from. Objective The aim of this study was to identify evidence-based alcohol education programmes for schools. Methods A systematic re...

Background: Anxiety and depression are common following traumatic brain injury (TBI), often co-occurring. This study evaluated the efficacy of a 9-week cognitive behavioral therapy (CBT) program in reducing anxiety and depression and whether a three-session motivational interviewing (MI) preparatory intervention increased treatment response. Meth...

The aim of this study was to undertake a systematic review on effective treatment options for co-occurring substance use and borderline personality disorders to examine effective treatments for this group. A systematic review using a narrative analysis approach was undertaken as there were too few studies within each intervention type to undertake...

This guide was developed to assist specialist and generalist clinicians to assess and respond to the needs of older people experiencing, or at risk of experiencing, alcohol- and other drug-(AOD) related harm. Longer life expectancy, more people living longer, and different expectations of current and future generations of older people will increase...

Background: Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of bene...

Purpose – The purpose of this paper is to identify mental health interventions within male-dominated industries. Design/methodology/approach – A systematic literature review was undertaken, examining mental health interventions within male-dominated industries. Major electronic databases, grey literature and reference lists for English language...

Background: Traditionally, men have been heavier drinkers of alcohol and at greater risk of health problems than women. As men are often reluctant to recognize or seek help for risky drinking, the workplace provides an ideal opportunity to implement and target interventions around risky alcohol use. Methods: A systematic literature review was under...

Background and Aims: Working conditions are an important health determinant. Employment factors can negatively affect mental health (MH), but there is little research on MH risk factors in male-dominated industries (MDI). Method: A systematic review of risk factors for anxiety and depression disorders in MDI was undertaken. MDI comprised ≥ 70% male...

Purpose ‐ The purpose of this paper is to examine test-retest reliability of the PsyCheck screening tool. Design/methodology/approach ‐ In all, 50 drug users in their first three months of treatment were given the Self Reporting Questionnaire (SRQ; PsyCheck version) at two time points between five and nine days apart to examine reliability of the s...

Cognitive behavior therapy (CBT) is an umbrella term that describes a group of therapies, that although many in number and broad in their approach, have in common a focus on thoughts and beliefs (cognitions) as the central driver of, and the solution to, effective emotion regulation . The early CBT models (sometimes referred to as the “first wave”)...

Objective: The paper highlights the extent of pharmaceutical drug misuse problems in Australia and explores how pharmaceutical opioid misuse could be reduced by implementation of a technological tool: a prescription co-ordination program (PCP). The paper explores how enhancements to existing computer-assisted clinical decision support systems thro...

Purpose – The aim of this study is to assess the feasibility of introducing clinical case management into a youth alcohol and other drug treatment setting. Design/methodology/approach – Case management as usual (CMAU), the current brokerage model operating as a control group was compared to clinical case management (CCM). Individual client outcome...

: To examine the relative effectiveness of brief interventions comprising an information booklet with and without a brief motivational interview and an informal discussion in reducing alcohol use following traumatic brain injury. : Sample of 60 participants with traumatic brain injury (mean age = 35 years) with preinjury history of alcohol use. : R...

: To investigate variables associated with the frequency and quantity of alcohol consumption following a brief alcohol intervention in individuals with traumatic brain injury. : Initial sample of 60 participants with traumatic brain injury (mean age = 35 years) with preinjury history of alcohol use; of whom, 50 were evaluated at follow-up. : Random...

Introduction and aims: There are no medications approved for the treatment of methamphetamine withdrawal. Wake-promoting agent modafinil has recently been proposed as a viable option. This paper reports on the results of a pilot study that tested the feasibility of modafinil in an inpatient withdrawal setting during acute methamphetamine withdrawa...

To evaluate the impact of community-based drug treatment on methamphetamine use using inverse probability of treatment-weighted (IPTW) estimators to derive treatment effects. A longitudinal prospective cohort study with follow-ups at 3 months, 1 year and 3 years. Treatment effects were derived by comparing groups at follow-up. IPTW estimators were...

Purpose The aim of this paper is to examine the temporal sequencing of methamphetamine use and the onset of mental health problems among a sample of dependent methamphetamine users. Design/methodology/approach The study used a self‐reported timeline method to examine the sequencing of first use, regular use and problematic use of methamphetamine a...

Volatile substance use (VSU) is associated with a range of adverse outcomes, including cognitive impairment and death. It occurs disproportionately within young and marginalized populations. A previous international systematic review of VSU treatment identified no relevant studies. This paper reports on a systematic review of a range of study types...

Purpose Dissemination of good practice information to practitioners is one of the great challenges of the substance abuse treatment sector. The authors' understanding of the process by which research is translated is limited, but a whole of workforce approach is considered best practice. This paper aims to examine organisational change as a result...

Recently, there has been considerable policy and public interest in the availability of over-the-counter (OTC) codeine. Case reports demonstrating severe harm from OTC codeine have been published. However, few studies have examined how people use these products and who develops dependence. The aim of this study was to better understand who develops...

Mental health problems are common among drug treatment clients with most symptoms related to anxiety and depression. In this study, we used an established manual for alcohol and drug practitioners known as PsyCheck that outlines basic mental health screening and intervention for high prevalence disorders. The aim of this study was to examine change...

To determine whether the presence of comorbid depression influences response to psychological treatment for methamphetamine use. Randomised controlled clinical trial. Our study was conducted between 2001 and 2005 at two sites in Australia: the Hunter Region of New South Wales and the city of Brisbane, Queensland. The 214 participants, who were all...

To determine the prevalence of major depression among people entering treatment for methamphetamine use. The study was a cross-sectional survey involving 41 specialised drug and alcohol treatment agencies in Brisbane and Sydney. Services provided by these agencies included residential rehabilitation, detoxification and counselling. Participants wer...

Rates of borderline personality disorder (BPD) among individuals with substance use disorder (SUD) are estimated to be as high as 65%. Such elevated rates present considerable challenges for drug treatment services given that individuals with co-occurring SUD and BPD have higher rates of relapse, treatment noncompliance, and poorer outcomes than th...

Aims: The comorbidity of substance use and mental health problems poses a significant challenge for alcohol and other drug (AOD) treatment services. In many cases, AOD practitioners do not have experience or training in identifying or managing mental health conditions. Methods: This project examined the implementation of screening and intervention...

Australia has one of the highest rates of methamphetamine use in the world; however, treatment access for methamphetamine is comparatively low. This descriptive study aimed to identify patterns of treatment utilization and perceived barriers to accessing treatment among dependent methamphetamine users in the hope that such information will enable s...

The cognitive benefits of modafinil to patients undergoing 7-day inpatient withdrawal from methamphetamine (MA) dependence were examined as part of a double-blind, randomized, placebo-controlled pilot trial. Recent evidence has identified modafinil-related improvements in treatment outcomes for MA-dependent patients; however, the benefits to cognit...

Stepped-care has been recommended in the alcohol and other drug field and adopted in a number of service settings, but few research projects have examined this approach. This article aims to describe a pilot trial of stepped-care methods in the treatment of methamphetamine use and depression comorbidity. An adaptive treatment strategy was developed...

Treatment seeking for methamphetamine withdrawal is low in Australia. Insufficient knowledge regarding the withdrawal syndrome of methamphetamine and the appropriate management of these symptoms may be a contributing factor to the low treatment attendance. A systematic review was performed using a range of electronic databases. Common methamphetami...

Background: Attitude to, and confidence in, working with comorbidity is an important feature of effective engagement when working with clients with mental health and substance use issues. Substance use treatment clinicians continue to voice concerns about their own skill and abilities to work with this complex client group. PsyCheck is a package de...

Craving is frequently reported as a trigger for relapse by those trying to remain abstinent from psychoactive substances. Metacognitive beliefs about managing craving may play an important role in determining further cognition and behavior. They are, therefore, important to measure in treatment and may serve as target cognitions to be modified in s...

Background: Mental health problems, particularly anxiety and mood disorders, are common among clients of alcohol and other drug treatment services, and symptom management is increasingly within the purview of alcohol and drug workers. A mental health screening toolkit, PsyCheck, was created for use by non-mental health specialists to detect common...

Despite the high prevalence of methamphetamine use and dependence in Australia, withdrawal treatment access for methamphetamine accounts for only 9.3% of total withdrawal treatment presentations. Furthermore, treatment completion for methamphetamine users is one of the lowest of all drugs. There is not a clear understanding for the reasons why meth...

There are a number of tools to assist services to measure their capacity to respond to co-occurring substance use and mental health disorders. This study aimed to examine whether services could accurately self-rate their dual diagnosis capacity. Data were collected from 13 alcohol and drug services across Australia that participated in a comorbidit...

Aim: To assess outcomes for methamphetamine users entering community-based drug treatment services. Participants: Methamphetamine treatment entrants (n = 400) from community-based drug treatment services (counselling, residential rehabilitation and detoxification) and a comparison group of out-of-treatment dependent methamphetamine users (n = 100)....

Depression and anxiety are common among clients presenting to drug and alcohol services. The implication of this is that treatments for depression and anxiety should be available within drug and alcohol treatment settings. We recommend a stepped care approach to depression and anxiety symptoms and disorders in drug and alcohol settings. Avenues ava...

To compare the characteristics and harms associated with injecting and smoking methamphetamine among methamphetamine treatment entrants. A structured face-to-face interview was used to assess demographics, drug use patterns and harms [physical and mental health, psychological distress, psychotic symptoms, crime and human immunodeficiency virus (HIV...

The use of methamphetamine is widespread and poses significant challenges for treatment providers. Much of the treatment knowledge about this group has been extrapolated from studies of treatment for cocaine dependence. Medications have been shown to be of limited effectiveness for methamphetamine users, making psychological interventions the treat...

To evaluate the feasibility and efficacy of routine opportunistic screening and brief intervention (BI) by ED staff to reduce high-risk alcohol consumption. This was an open, randomized controlled trial with allocation blinding performed over 12 months. Using the Paddington Alcohol Test, adult patients were screened for high-risk alcohol use. Conse...

To evaluate qualitative feedback from patients who received opportunistic screening and brief intervention for harmful alcohol use during an ED attendance; to evaluate emergency staff attitudes to performing alcohol screening and delivering opportunistic brief intervention; and to document process issues associated with the introduction of routine...

This study examined the nature and extent of methadone- and buprenorphine-related morbidity through a retrospective analysis of ambulance service records (N = 243) in Melbourne, Australia. Cases in which methadone and buprenorphine were implicated are examined. Demographic and presenting characteristics, transport outcomes, and other substance use...

The majority of alcohol related problems in the community are managed in general practice. Screening and provision of brief interventions by general practitioners can impact on morbidity and mortality. General practitioners also play a central role in the management of alcohol dependence. This article discusses risky drinking and the prevalence of...

To examine concurrent buprenorphine and benzodiazepine consumption and to compare opioid toxicity symptoms induced by methadone and buprenorphine, examining factors associated with the reporting of these symptoms. Self-report cross-sectional survey. Five needle syringe programmes and five opioid substitution treatment services in Melbourne, Austral...

Buprenorphine is dispensed primarily in community pharmacies in Victoria, with buprenorphine prescribing expanding nationally. The aim of this paper was to examine issues that affect the delivery of buprenorphine in the community setting. A cross-sectional survey was conducted of 282 pharmacies participating in the methadone and buprenorphine progr...

Psychostimulant withdrawal: natural history and options for intervention - Volume 18 Issue 6 - N Lee, A Harney, L Johns, A Pennay, P Kenny

The present study sought to replicate and extend a small pilot study conducted by Baker, Boggs & Lewin (2001) which demonstrated that brief interventions consisting of motivational interviewing and cognitive-behaviour therapy (CBT) were feasible and associated with better outcomes compared with a control condition. Randomized controlled trial (RCT)...

Aims: The present study extends the findings of a pilot study conducted among regular amphetamine users in Newcastle, NSW, in 1998. It compares key features between current participants in a state capital city (Brisbane) and a regional city (Newcastle) and between the 1998 and current Newcastle sample. Cross-sectional survey. Setting Brisbane and N...

This study used a novel cue exposure paradigm to investigate the differences between high- and low-risk drinkers in their desire to drink during a drinking session. Fifty-three self-selected participants were assigned to high- or low-risk drinking groups based on their self-reported consumption of alcohol, then compared on their desire to drink ove...