Home

Guiding Principles

Staff

Research Projects

Downloadable Documents

Training Programmes

Consultation/Liaison

Conferences


Publications


Links

ATRIG

Contact Us

Research Projects at the National Addiction Centre

The National Addiction Centre is involved in a number of funded projects which are identified under the headings Planned Research, Ongoing Research, Recently Completed, Publication and Dissemination Ongoing, and Past Research. The work of NAC research graduates and important NAC documents can also be viewed and downloaded via this site.

Planned Research
The 'Problem Food' Study
Ongoing Research
Treatment Evaluation of Alcohol and Mood (TEAM) Study
Youth Retention Study
Odyssey Youth Outcome Study
CUDIT Revision Study
The Effectiveness of Naltrexone in Reducing the Craving of People with Pathological Gambling
Resilience in Indigenous Health Networks
Nicotine Study
Development of Mäori AOD Services and Workforce in Aotearoa New Zealand
Recently Completed
Zonnic™ and Patch (ZAP) Smoking Cessation Study
Moana House Evaluation Project
Te Ariari o te Oranga: The Assessment and Management of People with Coexisting Mental Health and Substance Use Problems 2010
Takarangi Competency Framework
Intravenous Opioid Dependence in New Zealand
Experiences and Needs of Mäori Methadone Maintenance Treatment (MMT) Patients
The Alcohol and Drug Outcomes Project (ADOPT) - Part II
National Telephone Survey - 2008
National Telephone Survey of the AOD Workforce
BTP Five Year Follow-up
Project on Adolescent Cannabis and Cognition (PACC)
Youth and Nicotine Study
Brief Intervention Training for GPs
Pre-post Smoking Ban Study
The Brief Treatment Programme for Alcohol Dependence (BTP)
Publication and Dissemination Ongoing
Perceptions of Cannabis Use and Social Policy
Feasibility Trial: Pre-quit NRT
Brief Treatment Programme for Alcohol Dependence (BTP)
Naturalistic Treatment Outcome Project (NTOP)
Naturalistic Treatment Outcome Study - Five Year Follow-up
Methadone Treatment Index (MTI)
Körero Te Hïkoi - Mäori Men Talk the Walk of Addiction Treatment
Christchurch Outcome of Treatment for Depression Study
Early Psychosis Study
Spirituality in Addiction Treatment
Past Research
Christchurch Alcoholic Relapse Study (CARS)
The Alcohol and Drug Outcomes Project (ADOPT)
The South Island Methadone Project Report
Guidelines for Clinical Process Self-Evaluation in Alcohol and Drug Treatment Agencies
Assessment and Management of Coexisting Substance Use and Mental Health Disorders

Delivery of Treatment for People with Opioid Dependence in New Zealand

Graduate Research
NAC Research Graduates

 

Planned Research

 

Abstinence vs Moderation in Obesity Treatment: The 'Problem Food' Study
New Zealand is in the grip of an obesity epidemic with over 25% of the adult population registering a BMI =30. The obesity epidemic is one of the greatest contemporary challenges facing New Zealanders in terms of morbidity, cost and intervention effectiveness. People become obese by eating more than they need, but assisting people to eat a little less and exercise a little more with standard psychosocial treatment has produced limited results. In addition, some foods (what we call 'problem foods') encourage overeating, especially in people with obesity, although this varies amongst individuals. Despite knowing that 'problem foods' play a role in maintaining obesity, we do not yet know what the best advice is to give people about how they should handle their problem foods. This means that we do not know whether it is best to tell people to stop eating their problem foods altogether (abstinence) or whether we should tell them to cut down on the amount of their problem foods that they eat (moderation).

In the 'Problem Food' Study, headed by Professor Doug Sellman, we are investigating which advice is best to give to people with obesity to help them lose weight and maintain that weight loss. This is a randomised controlled trial of 250 obese participants (BMI 30-40) who are randomised to one of three conditions i) abstinence from problem foods, ii) moderation of problem foods or iii) wait list (receive no treatment for six months before being randomised to moderation or abstinence for six months). All participants receive six months of active treatment focusing on lifestyle change with support from a personal health coach. In addition, during that six months those in the abstinence group will attend Overeaters Anonymous groups and those in the moderation group will attend Weight Watchers. Four key outcomes sought are loss of body fat, increased physical fitness, improved nutrient intake and increased well-being. Recruitment will commence in 2009.

BACK TO TOP

 

Ongoing Research

 

Treatment Evaluation of Alcohol and Mood (TEAM) Study
This multi-site study, funded by the Health Research Council and the Ministry of Health, commenced in October 2006. Headed by Prof Doug Sellman, the TEAM study is a randomised controlled trial of combined pharmacotherapy for patients with coexisting alcohol dependence and a major depressive illness. All participants will receive 12 weeks of naltrexone, an anti-craving drug, and supportive clinical case management over the 24 week course of the study. Half of the group will be randomised to receive 12 weeks of Citalopram, an SSRI antidepressant, and half a placebo. Participants continue to receive clinical case management for a following 12 weeks after the end of the pharmacotherapy phase of the trial. A further 12-month follow-up will be conducted. Additional funding is also being sought to investigate genetic and pharmacokinetic factors in relation to treatment response. Recruitment is currently active in Whangarei, Bay of Islands, Auckland, Hamilton, Christchurch, Nelson, Blenheim and Dunedin.

BACK TO TOP

Naturalistic Treatment Outcome Study - Five Year Follow-up
We are about a quarter of the way through interviews for this sample of 102 former patients from CADS Hamilton and CADS Christchurch, all of whom were interviewed at the time of a treatment episode in 2000-2001 and again nine months later. Data generated from this study will provide the best information to date on longer term treatment outcome for New Zealand AOD treatment clients, as well as service utilisation patterns. Funded by ALAC, Dr Simon Adamson is principal investigator.

BACK TO TOP

Youth Retention Study
This study, led by Dr Ria Schroder, aims to identify factors associated with retention or early dropout from AOD treatment for youth (ie those aged 14-18 for this study). This is being investigated by interviewing 140 youth who have attended AOD treatment services during 2003-2004 in seven centres around New Zealand, covering residential, day programme, and outpatient services. This study will also gather valuable information on the current functioning of these former clients. To supplement the interviews with youth the study also includes questioning programme staff in relation to identified youth and for their general views on factors affecting retention. Clinical files are also accessed once permission has been gained.

BACK TO TOP

Odyssey Youth Outcome Study
Currently part way through interviewing 80 consecutive admissions to the Christchurch Odyssey Youth Day or Residential Programme. Interviews are conducted at treatment entry, six weeks, 12 weeks, six months and 12 months. The study will be examining multi-dimensional treatment outcome, including substance use, mental health, general health, social functioning, criminal activity and personality development, as well as gaining the youths' impressions of the treatment they are receiving. Significant others are interviewed at baseline, six months and 12 months to gain their views on the appropriateness of treatment provided, quality of family relationships and their impression of the youths' current functioning. This study will also examine factors related to retention, as well as predictors of outcome. The co-principal investigators are Professor Doug Sellman and Dr Ria Schroder.

BACK TO TOP

CUDIT Revision Study
The Cannabis Use Disorders Identification Test (Adamson & Sellman, Drug & Alcohol Review, 2003;22(3):309-15) was developed as a screening tool for cannabis abuse or dependence. A range of alternate items are currently being explored to improve the precision of this measure, led by Dr Simon Adamson and in collaboration with colleagues from the University of Newcastle, New South Wales. This study will also measure the test-retest reliability of the CUDIT and investigate the CUDIT’s sensitivity to change and therefore its potential as a brief measure of treatment outcome. The CUDIT is also being employed in the Odyssey Youth Outcome Study and Youth Retention Study (see above) where its appropriateness for an adolescent population will be examined.

BACK TO TOP

The Effectiveness of Naltrexone in Reducing the Craving of People with Pathological Gambling
This randomised controlled trial, which forms part of Dr Dominic Lim’s PhD work, is testing the effect of Naltrexone on gambling-related craving and gambling behaviour. It is nearing the end of the patient recruitment phase and the preliminary data analysis supports a positive role for naltrexone in reducing gambling craving and gambling behaviour.

BACK TO TOP

Resilience in Indigenous Health Networks
This project is being undertaken in collaboration with a Canadian indigenous research group, with Dr Paul Robertson as the principal investigator of the New Zealand arm. In addition to a stocktake, interviews with 57 Mäori working in various roles in the health sector have provided the basis for developing a framework for resilient indigenous health worker networks. Although the study is broadly focused on the range of health workers, Dr Robertson has a particular interest in the development and maintenance of Mäori addiction worker networks. The initial results of the study have been presented at conferences and hui in both Canada and New Zealand and a number of joint articles are currently being written up for publication.

BACK TO TOP

Nicotine Study
A survey of attitudes and service practices towards nicotine addiction and smoking cessation by the Canterbury Mental Health and Addiction Workforce.

A postal survey of 250 randomly selected mental health and alcohol and other drug clinicians in the Canterbury District Health Board has recently been conducted. Lead by Dr Mark Wallace-Bell and Dr Marie Ditchburn, the main purpose of this survey is to determine the prevalence and attitudes towards tobacco smoking and smoking cessation in mental health clinicians and their patients. It is hoped that the results of this study may help services and health care professionals develop and implement programmes to treat nicotine addiction.

BACK TO TOP

Development of Mäori AOD Services and Workforce in Aotearoa New Zealand
Tami Cave is the principal investigator for this project (funded through Matua Raki, the National Addiction Treatment Workforce Development Programme). The results of this study are in part based on interviews with 14 key informants - people who have played critical roles in the development of Mäori AOD services over the years. The study found that passion, committment and sound foundation in the principles and practices of Te Ao Mäori have been central to the successful development of the Mäori addiction treatment sector. As well as recording the history of the field, the results of the project provides the basis for identifying further areas for development as the Mäori addiction treatment sector continues to flourish, despite challenges in a number of areas. The initial results have previously been presented at a number of hui, as well as at the Cutting Edge Conference, however the full results, which are to be published in book form thanks to the efforts of Terry Huriwai, will be released at the end of March 2009 at a ceremony to be held at Owhata Marae, Rotorua.

BACKTO TOP

 

Recently Completed

 

Zonnic™ and Patch (ZAP) Smoking Cessation Study
This three site study, funded by the Health Research Council, commenced in February 2010 and recently concluded in July 2012. Headed by Professor Julian Crane from the Wellington School of Medicine, the ZAP study is a randomised controlled trial of nicotine patch plus Zonnic™ active nicotine mouth spray compared to nicotine patch plus placebo Zonnic™ mouth spray. This study sought to test the effect on quit rates of giving Zonnic™ plus standard therapy, using a double-blind randomised placebo design. As 88% of tobacco smokers are unable to quit with nicotine patches alone, Zonnic™ may provide a way for them to quit and stay quit long-term.


All participants received five months of nicotine patch therapy and six months Zonnic™. Psychological counselling was provided, using Appreciative Inquiry, in addition to the NRT. The study had a duration of 13 months with participants required to make five visits to a researcher at either the University of Otago (Wellington or Christchurch) or Kokiri Marae in Wellington. Quit rates at 12 months were determined by self-report and verified by biological measures. The data is currently being analysed and findings written for publication. Further enquiry can be made to Dr Brent Caldwell at the Wellington School of Medicine brent.caldwell@otago.ac.nz.

BACK TO TOP

Moana House Evaluation Project
Moana House is a Dunedin-based therapeutic community tailored to the treatment needs of men with both addiction issues and offending histories. It has a strong bicultural focus while also accommodating a range of other cultures and individual needs. Because of increasing concern at the unmet demand for substance abuse treatment for offender populations, and Moana House's reputation as a long-standing and well respected programme working with the more difficult end of this population, ALAC funded an outcome evaluation to determine how effective the programme was in achieving its therapeutic goals and the feasibility of replicating this treatment model in other locations. The NAC, led by Dr Simon Adamson, undertook an evaluation using a mixed methods approach, combining both objective measures of residents at intake, and change over the course of treatment and discharge, as well as in-depth interviews with residents about their treatment experience. The evaluation also involved interviews with a wide range of people involved with the House: staff, ex-residents, whanau, referrers, funders and community members. Assessments and interviews continued through to early 2010, with a final report submitted to ALAC in September 2010.

BACK TO TOP

Te Ariari o te Oranga: The Assessment and Management of People with Coexisting Mental Health and Substance Use Problems 2010
This document is designed to update the 1998 clinical guidelines The Assessment and Management of People with Coexisting Substance Use and Mental Health Disorders (Todd et al. 1998). Much of the content of the 1998 guidelines remains relevant, but there have been important developments in research and practice. This document is now available to be downloaded from the Ministry of Health website.

BACK TO TOP

Takarangi Competency Framework
This competency framework was been developed and piloted in a variety of addiction and mental health services and involved a range of practitioners. It builds on the work of a number of people and hui held over the past decade and is a fusion of clinical and Mäori features leading to a competent practitioner. The Takarangi Framework is Mäori-centric and has a strong quality assurance feature. It has synergies with the Real Skills project and currently Matua Raki is holding discussions with a number of other competency frameworks and professional bodies to ensure alignment. For further information contact terry.huriwai@otago.ac.nz.

BACKTO TOP

Intravenous Opioid Dependence in New Zealand
This research project, funded by the Ministry of Health and led by the National Addiction Centre, was undertaken in collaboration with the Aotearoa Alcohol and Other Drug Consumer Network, Needle Exchange Services (NEST) and Needle Exchange NZ (NENZ) Trusts and the University of Auckland. The research addressed six key questions related to the prevalence of opioid dependence in New Zealand, demand for treatment, barriers to treatment, the number of people being treated with opioid substitution treatment (OST) in specialist services and by GPs in primary care, waiting times for treatment and the influence of the methamphetamine epidemic. The research primarily consisted of two surveys; one of regular opioid users (daily or almost daily) of whom some were receiving treatment, some had received treatment in the past and some had never received treatment, and the other of the 18 OST Services.


Key findings were: 1) the number of people estimated to be daily (or near daily opioid drug users) was 9,953 of whom about half were receiving treatment (4,608) and 2) that even though there continues to be in many localities considerable waiting time for treatment, the opioid user survey indicated that there is considerable ambivalence, not only on the part of those not currently receiving OST but also those in treatment, about the delivery of OST. With the exception of staff attitudes, similar barriers to treatment were identified by both service providers and opioid users. These included lack of treatment flexibility and the impact of stigma. Almost all specialist service providers identified resource issues and barriers to transferring clients to primary care for continuing treatment following stabilisation. The primary treatment recommendation, supported by eight secondary recommendations was for a renewed effort to attract people with opioid dependence into treatment with the aim of integrating OST with mainstream health services and OST clients into their communities. Secondary recommendations focused on improving client centred treatment including accessibility, reviewing staffing qualifications and treatment philosophies, increasing consumer input into programmes and establishing peer support roles, ensuring adequate psychosocial resources, funding buprenorphine as an alternative substitution medication and increasing primary care OST prescribers, including nurse practitioners. Dr Daryle Deering is continuing to lead research into opioid addiction at the NAC.

The report and accompanying appendices one, two and three are available for viewing and downloading.

BACK TO TOP

Experiences and Needs of Mäori Methadone Maintenance Treatment (MMT) Patients
Under the supervision of Dr Paul Robertson and Christchurch Methadone Programme staff Ra Bates and Wiki Crofts, a Mäori medical student (Courtney Hore) interviewed nine Mäori MMT patients, asking about their wants, needs and experiences of MMT. All participants identified the benefits of attending a Mäori focused whanau clinic, with several also noting how re-engaging with Te Ao Mäori was contributing to their recovery. Courtney has presented the results at a seminar at the University of Otago, Christchurch, and it is hoped that the results will be published in the near future.

BACK TO TOP

The Alcohol and Drug Outcomes Project (ADOPT) - Part II
ADOPT II, which led to the development and psychometric testing of the brief, generic Alcohol and Drug Outcome Measure (ADOM) was funded by Te Pou, The National Centre of Mental Health Research, Information and Workforce Development, and led by Dr Gail Robinson (Waitemata DHB) and Dr Daryle Deering (NAC). ADOPT II built on the foundation work undertaken in ADOPT I of implementing routine outcome measurement with clients in alcohol and other drug (AOD) treatment services (refer to Alcohol and Drug Outcomes Project (ADOPT) (Deering et al 2004) which is freely available for downloading at the Te Pou website.

The ADOM was designed for routine use by AOD clinicians and their clients to monitor client outcomes during treatment with a view to increasing client participation in their treatment and improving treatment responsiveness. The development of the ADOM was informed by an expert panel of AOD clincians, key informant interviews and a pilot with clients and their respective clinicians. The psychometric properties (validity, test-retest reliability and sensitivity to change) of the ADOM were then tested with clients across a range of outpatient AOD treatment services in two urban settings. Psychometric testing showed excellent results for Part A covering type and frequency of substance use and injecting risk. Results for Part B, covering physical and mental health and social issues, were less impressive, but generally satisfactory and highlighted areas for further developmental consideration. The research team recommended field testing of the ADOM in a small number of services with particular attention paid to uptake and perceived clinical utility and with a view to further refinements of Part B. The peer reviewed report titled Preliminary Work Towards Validating a Draft Outcome Measure for Use in the Alcohol and Drug Sector (Deering et al 2009), a summary report and fact sheet are freely available for downloading from the Te Pou website. The implementation of ADOM nationally is being considered by the Ministry of Health. Dr Deering continues to be the NAC contact person with respect to the ADOM.

BACK TO TOP

National Telephone Survey - 2008
In 2008 we repeated the successful telephone surveys of the AOD workforce previously conducted in 1998 and 2004, allowing us to continue to monitor changes in the qualifications, practice, knowledge and attitudes of our workforce, as well as obtain a nationally representative snapshot of clients. The current survey is now available to be downloaded.

BACK TO TOP

National Telephone Survey of the AOD Workforce
This data continues to be disseminated and papers on the client profile, identification of nicotine use, and a vision for the future of the AOD workforce are in the pipeline. In addition to the 'main' study, there were two follow-on studies. All Mäori AOD workers interviewed agreed to a further interview with a Mäori research assistant. Paul Robertson and Tami Gibson have disseminated some of the findings and a paper is in preparation. All nurses taking part in the main study were asked to participate in a further interview to explore issues of nursing practice on AOD settings. A paper is currently being prepared for publication.

BACK TO TOP

BTP Five Year Follow-up
The five year follow-up data from this randomised controlled trial of motivational enhancement therapy was presented to a conference in Santa Fe, New Mexico in January 2006.

BACK TO TOP

Project on Adolescent Cannabis and Cognition (PACC)
Meg Harvey (former Assistant Research Fellow) analysed and wrote up her PhD research on cannabis use and cognition in an adolescent sample.

BACK TO TOP

Youth and Nicotine Study
Marie Ditchburn (Research Fellow) analysed baseline and follow-up data over a four year period for this clinical youth population in relation to their nicotine use as part of her PhD work. The main aims of this research were to 1) determine the prevalence rate of tobacco smoking among patients presenting with symptoms of mental disorders at an outpatient adolescent mental health service; 2) ascertain the overall stability of smoking behaviour and estimate regular smokers degree of nicotine dependence over time; and 3) investigate potential factors and mechanisms associated with the continuation and discontinuation of smoking.

Smoking was found to be common among adolescents presenting to an outpatient mental health service. For the vast majority of smokers first identified, smoking remained stable over time, with only five who were smoking tobacco at baseline discontinuing by follow-up. The hallmarks of dependence present at baseline persisted over time, with the severity of dependence generally increasing. Only problematic alcohol use and peer influences continued to be uniquely associated with smoking over time. However, as subjects got older, smokers displayed more symptoms of depression than non-smokers.

BACK TO TOP

Brief Intervention Training for GPs
Doug Sellman (Director) evaluated the impact of a brief intervention training session with a group of general practitioners.

BACK TO TOP

Pre-post Smoking Ban Study
As part of the same research group, Mark was part of a study which took breath and air samples in casinos and bars before and after the Smokefree Environments Amendment Bill came into effect in December 2004.

BACK TO TOP

 

Publication and Dissemination Ongoing

 

Perceptions of Cannabis Use and Social Policy
Geoff Noller prepared a paper on harm reduction and the National Drug Policy as part of his PhD work.

Feasibility Trial: Pre-quit NRT
Mark Wallace-Bell is part of a research group based at the University of Auckland and has completed a feasibility trial of nicotine replacement therapy initiated prior to smoking cessation.

Brief Treatment Programme for Alcohol Dependence (BTP)
This was a randomised controlled trial of Motivational Enhancement Therapy (MET). A book chapter (Sellman et al.) is currently in press and I intend to publish findings on the prediction of treatment outcome in the sample. Samadhi Campbell (Masters candidate) will be coding audiotapes of MET sessions to test hypotheses related to the interaction between client and therapist behaviour and impact on outcome. A second potential masters student is currently considering examining this data also.

BACK TO TOP

Naturalistic Treatment Outcome Project (NTOP)
Baseline data on coexisting conditions and mental health treatment utilisation is currently in press (Adamson et al.) and further papers are to follow examining treatment outcome at nine months and examination of groups with specific co-existing conditions such as social phobia. Steve Marshall (Masters candidate) is analysing data on the association between cannabis use and depression in the sample.

BACK TO TOP

Methadone Treatment Index (MTI) Development
Daryle Deering (Senior Lecturer) continued to develop this brief multi-dimensional outcome instrument designed for routine use with clients receiving opioid substitution treatment as part of her PhD (completed 2007) with a paper on its psychometric properties recently published in Substance Use and Misuse, refer: Deering D, Sellman JD, Adamson S, Horn J, Frampton C. Development of a brief treatment instrument for routine clinical use with methadone maintenance treatment clients: The Methadone Treatment Index. Substance Use and Misuse 2008;43(11):1666-1680. Copies of the Methadone Treatment Index are available to be downloaded.

BACK TO TOP

Körero Te Hïkoi - Mäori Men Talk the Walk of Addiction Treatment
The work undertaken by Paul Robertson (Senior Lecturer Hauora Mäori) for his PhD on the experience and beliefs of Mäori men who have undertaken addiction treatment continues to be disseminated, including via recently submitted articles for peer reviewed publication.

BACK TO TOP

Christchurch Outcome of Treatment for Depression Study
Fraser Todd (Senior Lecturer) is a co-investigator on this study and has used data on the association between cannabis use and psychotic symptoms, and cannabis use as a predictor of treatment response to form the basis of his completed PhD.

BACK TO TOP

Early Psychosis Study
Again, Fraser Todd is a co-investigator and is particularly interested in the role of cannabis use in the emergence and course of psychosis in this population of first-presentations with psychosis.

BACK TO TOP

Spirituality in Addiction Treatment
Michael Baker has completed his PhD having undertaken a thorough investigation of spirituality with a prospective inpatient treatment population.

BACK TO TOP

 

Past Research


Christchurch Alcoholic Relapse Study (CARS)
This study examined the results of a Prolactin response to Fenfluramine test administered to this sample. Prolactin levels in the bloodstream are used as a marker of CNS serotonin activity. It is hypothesised that reduced serotonin activity may predict worse treatment outcome.

BACK TO TOP


The Collaborative Mäori Project was the first NAC investigation into optimum treatment for Mäori with alcohol and drug problems. It consisted of a survey of Mäori currently being treated for alcohol and drug problems in two Mäori dedicated services and four non-Mäori services. A series of questions put to the 105 Mäori participants aimed to assess how important cultural factors are considered to be in the provision of optimal treatment for Mäori. Over 90% of those interviewed considered that experiencing and learning Mäori protocols and practices was an important ingredient in an effective treatment programme.

BACK TO TOP

The National Telephone Survey (1998 and 2004) of alcohol and drug treatment workers in New Zealand investigated the current practice, knowledge and attitudes of clinicians working with alcohol and drug patients in New Zealand. In addition, it provided a description of the level of experience and qualification of clinicians as well as revealing a picture of a representative sample of clients seen at dedicated alcohol and drug services. Two subsequent studies were:

BACK TO TOP

Survey of School Guidance Counsellors in the Christchurch Area was a follow-on from the national survey of alcohol and drug workers and gathered similar information relating to the current practice and attitudes of school guidance counsellors.

BACK TO TOP

The Rolling Telephone Survey started in June 1999 and was a follow on from the National Telephone Survey. From 1999 to 2002 this project investigated patterns of drug use by those presenting for alcohol and drug treatment in New Zealand. It involved yearly random samples of alcohol and drug clinicians in New Zealand and collecting data about the drug use of the last client they assessed. Part of this study involved compiling and updating a complete database of alcohol and drug services and workers in New Zealand and monitoring the workforce.

BACK TO TOP

The Degree of Drug Use Index Validity Study (DDIVS)
The investigators are Daryle Deering (Principal Investigator), Doug Sellman, Simon Adamson (National Addiction Centre) and Tuari Potiki (Ngai Tahu Development). This study, conducted in a research setting, comprised part of the research undertaken by Daryle Deering (Lecturer) for her PhD on methadone treatment in New Zealand. The overall goal of this project, funded by the Health Research Council of New Zealand, was to further develop the Methadone Treatment index (MTI), a multi-dimensional brief outcome instrument for routine use with clients receiving methadone treatment. More specifically, this project investigated feasibility and psychometric properties of the first section of the MTI, the Degree of Drug Use Index (DDI), with random samples of Mäori and non-Mäori clients receiving methadone treatment. Feedback on feasibility characteristics was also sought from clinical staff members working in a range of methadone treatment programme settings. Results showed that the DDI was acceptable to both Mäori and non-Mäori clients, was a valid instrument and sensitive to measuring changes in clients' reported substance use. An important issue raised by clients and staff was the issue of validity of self-report within clinical settings in which clients perceived that negative sanctions may be invoked for illicit substance use. A paper on the development of the Methadone Treatment Index and psychometric properties is currently in press (Substance Use & Misuse).

BACK TO TOP

Te Aka Roa o Te Oranga (TAROTO)
(The far reaching vines of wellness)

Mäori Alcohol and Drug Treatment Evaluation and Development

Investigative Team:

  • Paul Robertson (Kai Tahu) - Project Leader, National Addiction Centre, Christchurch;
  • Titari Eramiha (Ngati Mahia, Ngapuhi) - Kaumatua, Te Roopu Whakapiringa, Dargaville;
  • Pam Armstrong (Ngati Whatua, Ngati Wai) - Interim Mäori Project Manager, Matua Raki;
  • Annette Harris (Ngati Kahungunu) - Alcohol and Drug Service Team Leader, Hastings;
  • Suzanne Pitama (Ngati Kahungunu), Mäori/Indigenous Health Institute (MIHI), Christchurch;
  • Fraser Todd, National Addiction Centre, Christchurch;
  • Terry Huriwai (Te Arawa/Ngati Porou), Ministry of Health, Christchurch.

The main objective of this project was to articulate, evaluate and develop elements of Mäori focused alcohol and drug treatment. TAROTO was developed as a result of several consultation hui with key people from the national Mäori alcohol and drug field.

Phase 1, funded by ALAC, consisted of a developmental evaluation of two existing Mäori services. This pilot phase involved gathering information from a variety of sources, including clients, whanau, staff (including kuia and kaumatua) and management. The framework included consideration of the context in which a service is delivered.

The primary outcome of the pilot was development will be an evaluation tool consisting of five components/questionnaires which focus on: 1) the client; 2) the whanau; 3) Tikanga; 4) the staff, 5) systemic and structural issues. It is envisaged that services will use this tool to audit their provision of service to Mäori clients. Phase 2 of TAROTO (yet to be fully developed and funded) will involve validation of this tool at several other services around New Zealand, both Mäori and non-Mäori.

TAROTO was firmly based in a kaupapa Mäori research framework, as described by a number of Mäori researchers (for example, Linda and Graham Smith, Fiona Cram). In light of this efforts were made to ensure that:

  • The objectives of the project explicitly reflected Mäori values, beliefs and experiences;
  • The research process included processes to ensure ongoing accountability to the people from whom the information was gathered;
  • Appropriate cultural protocols are followed within the research process as a whole and individual interviews to support joint ownership and accountability to participants;
  • Appropriate tools and analytic frameworks were employed to minimise bias in analysis and ensure protection of Mäori values, beliefs and experiences;
  • Results and other information about the project were disseminated in ways that were accessible to the range of people involved in the project.

The Alcohol and Drug Outcomes Project (ADOPT) investigated alcohol and other drug treatment outcome measures with a view to preliminary work towards a measurement system. Daryle Deering (NAC) and Gail Robinson of the Clinical Research and Resource Centre (CRRC), Auckland, were Co-Principal Investigators on this project which was commissioned by Mental Health Research and Development Strategy. Paul Robertson, Simon Adamson and Meg Harvey (NAC)) were also Investigators along with Amanda Wheeler (CRRC), Gareth Edwards (CRRC), Grant Paton-Simpson (Waitemata Health) and Helen Warren (University of Auckland).

The ADOPT report is now available to be downloaded.

BACK TO TOP

The South Island Methadone Project Report was commissioned by the Ministry of Health. It investigated and described methadone treatment provision in the South Island in terms of referral and access, waiting list management and transfers between programmes. The report highlights a serious crisis within at least three of the six South Island programmes and makes several recommendations aimed at reducing waiting times and increasing consistency.

Download this document in pdf format directly : (90 Kb)

BACK TO TOP

The Guidelines for Clinical Process Self-Evaluation in Alcohol and Drug Treatment Agencies were developed in 1997-1998 through a process of literature review and consultation with providers, consumers and funders. The guidelines, which compliment relevant accreditation standards and the Ministry of Health Mental Health Standards (1997) were published and disseminated to agencies by ALAC in 1999. Helen Mitchell-Shand is currently funded to provide a consultation service to assist agencies with implementation.

Download this document in pdf format directly: (4475 Kb)

BACK TO TOP

Assessment and Management of Co-existing Substance Use and Mental Health Disorders is a project which aims to provide practical guidelines for clinicians and services, both mental health and alcohol and drug, in their work with comorbidity patients. The project is focused on eight clinical vignettes designed to cover the common, difficult comorbidity problems that arise in New Zealand and considers a wide range of factors impacting on maintenance and treatment of these problems, including cultural variables.

Download this document in pdf format directly: (7224 Kb)

BACK TO TOP

Delivery of Treatment for People with Opioid Dependence in New Zealand was the paper produced in the course of the National Addiction Centre's first development project in 1996 and was commissioned by the Ministry of Health. It was estimated then that there are 13,500 - 26,600 people with opioid dependence in New Zealand, with this population predicted to grow by 15% per year for the foreseeable future. A range of options for delivering treatment to this expanding group of patients were assembled and carefully considered including a cost-benefit analysis. An "integrated model" was finally recommended in which it was anticipated that 80% of opioid dependent patients would be cared for directly by general medical practitioners in primary care with the balance managed by specialist clinics.

Download this document in pdf format directly: (529 Kb)
Or visit the Ministry of Health website.

To download these files you will need Adobe Reader. To obtain a free copy please visit the Adobe website:

 


BACK TO TOP

 
NAC RESEARCH GRADUATES

 

Since its inception in 1996, the National Addiction Centre has seen a number of its students graduate to MHealSci and PhD level. Abstracts of research graduates are now available to view and download.

 

BACK TO TOP


Department of Psychological Medicine
University of Otago, Christchurch
PO Box 4345, Christchurch 8140, New Zealand
Telephone: +64-3-364-0480
Fax: +64-3-364-1225

Comments to
:
simon.adamson@otago.ac.nz
Last updated: August 2012