Changing the Game: 30 Years of Drug and Alcohol Research
To mark its 30th anniversary the National Drug and Alcohol Research Centre (NDARC) at UNSW has released a report looking back at 30 years of drug and alcohol research in Australia.
The report, Changing the Game: 30 Years of Drug and Alcohol Research, covers highlights from NDARC’s history and explores the social and political context behind some of the Centre’s biggest projects.
NDARC was officially opened in 1987 in a political climate influenced by Prime Minister, Bob Hawke’s personal connection to the nation’s drug problem – his daughter had been using heroin.
Propelled by his family crisis, Hawke called a special Premier’s conference in 1985 to plan a national drug strategy which led to the launch of the National Campaign Against Drug Abuse and approval of the proposal for a national research centre focussing on treatment and rehabilitation.
NDARC began as a research centre of the University of NSW Sydney in 1986 and officially opened on 27th November 1987 following the appointment of its inaugural director Professor Nick Heather.
The report is organised into four decades: the 1980s, 1990s, 2000s and 2010s and looks at the social and political context which drove its research programs.
Highlighted research includes:
- A world first review of research on methadone maintenance treatment which found convincing evidence of the effectiveness of methadone in reducing heroin use and was used to provide policy advice at Federal and state level.
- A world first trial of methadone treatment in prisons cited by the World Health Organisation as the most important piece of evidence on methadone treatment in prisons.
- A review of the mental health effects of cannabis use which found some of the first evidence that cannabis could produce dependence and adverse psychosocial outcomes. At the time most people did not believe cannabis dependence existed or needed treatment.
- The 1990s heroin epidemic: A review of fatal heroin overdose in the first five years found 1,000 cases mainly involving people in their 20s and 30s.
- The First National Survey of Mental Health and Wellbeing found high levels of co-occurrence of anxiety, depression and addiction. The findings led to the Commonwealth establishing the National Comorbidity Initiative.
- Report on the heroin shortage: While the 1990s was to an extent the decade of heroin, the early 2000s saw a sudden and substantial drop in heroin supply in Australia. While this led to a drop in fatal heroin overdose other drugs of dependence emerged to take its place – most notably methamphetamine.
- The methamphetamine treatment evaluation study (MATES): An increase in methamphetamine use emerged in the early 2000s but research from NDARC found that treatment options were limited and ineffective. The study also produced important evidence of mental health issues among people who used methamphetamine. It found that there was increased risk of psychosis and violence when people were using more often and at higher doses.
- Prevention programs: In 2002 NDARC commenced its ongoing work on prevention, developing and evaluating the first online prevention programs which were shown to be effective in reducing school aged children’s use of alcohol and other drugs. Climate Schools was trialled with over 14,000 students. The program of research continues today and has been rolled out in the UK and the US.
- National evaluation of pharmacotherapies for opioid dependence (NEPOD): By the late 1990s views on treatment of heroin were highly polarised. Complicating the debate was a 1998 tour of Australia by Israeli based Doctor Andre Waismann claiming he had a cure for dependence – rapid detoxification under anaesthetic followed by ongoing treatment with naltrexone. The evaluation integrated data on costs and effects of methadone, buprenorphine and naltrexone from 13 trials and 1,400 users providing governments with robust evidence on which to base policy.
2010 and beyond
- Global Burden of Disease (GBD): When the centre opened very little was known about the patterns and harms of drug use and dependence in Australia. NDARC’s program of epidemiological research means we now have a reasonable picture of most countries in the world. The GBD found that Australia and the US are the only two high income countries where drug use disorders are a top 10 causes of disability. Globally, deaths and disability related to illicit drug use has increased by a third over the past 10 years.
- Australian Parental Supply of Alcohol Study: This landmark study has followed 2,000 adolescents and their parents for six years commencing in year 7 and 8. It has produced the most convincing evidence to date that parents who supply their children with alcohol, even supervised and with the best of intentions, increase their chances of progressing to harmful and binge drinking by late adolescence.
- Centre of Research Excellence in Mental Health and Substance Use (CREMS): CREMS was funded by the NHMRC in 2012 and has generated new evidence around prevention and treatment. A significant recent achievement has been the development of the Federally funded $5 million Positive Choices and Cracks in the Ice portals.
- Monitoring of online markets and psychoactive substances: NDARC led national programs monitoring drugs since the early 1990s through the Illicit Drugs Reporting System (IDRS) and the Ecstasy and Related Drugs Reporting System (EDRS). The 2010s have seen a rapid increase in the availability of synthetic drugs and in the use of online marketplaces. Our monitoring programs have evolved with these developments.
- Pharmaceutical opioids: In the latter half of the decade we have seen opioid deaths begin to increase again. In contrast to the 1990s, two thirds of these deaths are attributable to pharmaceutical opioids rather than heroin. The POINT study has been documenting patterns of prescribing and related harms in more than 1,600 patients prescribed opioids for pain. The majority of these patients are taking multiple drugs and living with multiple conditions, particularly depression, all contributing to their risk of harm.
Professor Michael Farrell Director of NDARC welcomed the opportunity to review the work of the centre but acknowledged that while much has been achieved great challenges lay ahead.
“When the centre was established very little was known about the distribution and determinants of drug use and related harms, and still less about effective treatment and prevention,” said Professor Farrell.
“We have made huge progress particularly in reducing harms related to illicit drug use and infectious diseases. But the pace of change and the need to incorporate new technology and respond to the worldwide challenge of drug and alcohol use has not lost its momentum.
“Our challenge ahead is to continue to make a strong and impactful contribution to the health and wellbeing of the community and to reduce the burden of disease through our capacity to translate our research into policy and clinical practice.”
You can view Changing the Game: 30 Years of Drug and Alcohol Research on the NDARC website.
The National Drug and Alcohol Research Centre (NDARC) is supported by funding from the Australian Government under the Alcohol and Drug Program
NDARC was officially opened on 27 November 1987 by ALP Senator Susan Ryan.