Substance use

Substance use

OVERVIEW

The Substance Use Research Group (SURGe) seeks to improve understanding of substance use and substance use disorders, as well as their interaction with mental illness, in young people. We focus on developing and testing new early interventions and treatments for youth to reduce the harms of substance use across the life span.

A new research direction aims to explore the potentially therapeutic effects of some substances that are also used recreationally.

WHY IS THIS RESEARCH IMPORTANT?

Experimentation with substances like alcohol, cannabis, and tobacco typically begins in adolescence. While most young people who use substances do not go on to have problems, a subset will develop harmful patterns of use, known as substance use disorder. Globally, the peak age of onset for substance use disorder is 19.5 years old. Onset during this period of rapid social and neurobiological development carries risks of disruption to the developmental trajectory, setting the stage for future difficulties.

Despite this, most treatments for substance use disorder are oriented towards severe substance use disorder in older populations. Our research aims to refocus on earlier stages of substance use disorder to disrupt or delay progression and reduce longer-term harms. Early intervention for substance use disorders is in its infancy; new and innovative approaches are needed to effectively engage young people at this stage.

KEY QUESTIONS

  • How do substance use disorders emerge in young people?
  • Can we define and operationalise early stage substance use disorders?
  • Is mental health treatment seeking in young people an opportunity for early intervention for substance use disorder, given the overlap between substance use problems and mental illness?
  • What early intervention programs are most effective for different types of young people?
  • What treatments for different substance use disorders are efficacious and acceptable in young people?
  • Can some recreational drugs (e.g., MDMA, ketamine) produce therapeutic effects under some circumstances?

Read about studies that are currently recruiting HERE .

Surge study summaries

MYSS-HYPE

A Pilot Study of Contingency Management for Smoking Cessation in Young People with Borderline Personality Disorder features

Young people with Borderline Personality Disorder (BPD) features have much higher rates of cigarette smoking than other young Australians. Unfortunately, routine clinical care does not reduce these high smoking rates. Proactive, early intervention approaches are needed to address cigarette smoking in this population.

Our group is running the MYSS-HYPE pilot study to help young people aged 15-25 years with BPD features to quit smoking. This study is evaluating contingency management for smoking cessation in this population. Contingency management is an intensive behavioural intervention that uses targeted financial rewards to motivate and support abstinence from cigarettes.

Orygen Contributors: A/Prof Gill Bedi, A/Prof Jennifer Betts, Dr Eddie Mullen, Prof Andrew Chanen

 

INTEGRATE

Integrated Treatment for Young People with Psychological Distress

The INTEGRATE study is a randomised controlled trial looking at a new integrated psychological treatment that addresses mental health difficulties and associated problems in young people aged 12-25. The INTEGRATE treatment aims to teach young people coping skills to reduce anxiety, depression, difficulties at work or school, and reduce problems with alcohol or substance use.

The trial is now in follow up phase, due to be completed in mid-2024.

Orygen Contributors: A/Prof Gill Bedi, Prof Patrick McGorry, Prof Andrew Chanen, Prof Eoin Killackey, Dr Hok Pan Yuen, Dr Alexandre Guerin

 

MASKOT 

Testing novel medications for methamphetamine use in Young People

There are no established medications for methamphetamine use. While psychotherapy is effective for some people, relapse after treatment is a common challenge. There is a need to identify new medications for methamphetamine use, and to test them in young people, where methamphetamine use is most prevalent. The MASKOT pilot studies aim to investigate a novel medication for methamphetamine use in young people aged 15-35 years old.

MASKOT is run out of Orygen in Melbourne, Australia.

Orygen Contributors: A/Prof Gill Bedi, Dr Eddie Mullen, Dr Enrico Cementon, Prof Andrew Chanen, Dr Alexandre Guerin

 

GRACE

Guanfacine extended-release Randomised controlled trial for Adolescents with Cannabis usE (GRACE)

Cannabis use accounts for more than 60% of presentations to youth substance use treatment services in Australia. There are no established medications to help people manage their cannabis use. While counselling alone works for some people, combining medication and psychological support is often the best option for people who use other substances. The aim of this randomised controlled trial is to assess whether a novel medication when added to treatment as usual improves outcomes in young people aged 12-25 seeking help for their cannabis use. This study is a partnership with the Youth Support and Advocacy Service (YSAS). GRACE is currently recruiting via YSAS services.

Orygen Contributors: A/Prof Gill Bedi, Dr Emily Karanges, Dr Eddie Mullen, Dr Enrico Cementon, Prof Andrew Chanen

YSAS Contributors: Aji Akintola, Andrew Bruun

 

PAPAYA

Pharmaceutical-Assisted Psychotherapy for social Anxiety in Young people on the Autism spectrum (PAPAYA)

There are limited effective treatments for social anxiety in autistic young people. While psychotherapy and medications such as antidepressants can be effective, many autistic young people continue to experience distressing social anxiety even after these treatments. There is a need to test new treatments that might help autistic young people who are experiencing social anxiety.

PAPAYA is a randomised controlled trial that will test whether a novel medication-assisted psychotherapy approach improves social anxiety in young autistic people. PAPAYA is currently in the start-up phase. It will be run out of Orygen and headspace centres in Melbourne as well as the Brain and Mind Research Institute in Sydney, Australia.

Orygen Contributors: A/Prof Gill Bedi, Prof Patrick McGorry, Prof Andrew Chanen, Dr Eddie Mullen, Prof David Coghill, Prof Stephen Wood, Dr Hok Pan Yuen, Dr Alexandre Guerin

Brain and Mind Research Institute Contributors: Prof Adam Guastella, Prof Ian Hickie, Dr Kelsie Boulton