Matua Raḵi August 2016 newsletter
The National Addiction Research Symposium has been held since 2010 as a collaborative venture between the University of Auckland, University of Otago, Massey University and Victoria University of Wellington, with support from Matua Raḵi.
This year Victoria University of Wellington hosted presenters and participants, and an impressive line-up of oral and poster presentations exemplified the diversity of addiction research. The supportive networking environment facilitated opportunities to share ideas and initiatives among senior researchers, clinicians, students and policy-makers involved in the addiction field.
Professor Piri Sciascia, (Ngāti Kahungunu, Kāi Tahu) deputy vice chancellor (Māori) opened the day. Acknowledging the challenges and ‘te po’ (the darkness) that may be synonymous with addiction, he also affirmed the work done by those working in the sector with tāngata whai ora and whānau that lifts some of that darkness. His kōrero paved the way for a day of sharing, learning and understanding.
Key information from the presentations
Professor Eric Donny, from the University of Pittsburgh and in New Zealand on sabbatical, gave the opening address. He spoke on his research investigating the Science and Potential Public Health Impact of Reducing Nicotine in Cigarettes, summarising years of research and providing an insight into the impact of nicotine use, nicotine alternatives and smoking reduction.
Dr Penny Truman (Massey University) continued the smoking theme, questioning why – if it is nicotine sought in dependence – there is not abuse of nicotine replacement therapies (NRT). She suggested the impact of ‘chemical x’ (perhaps monoamine oxidase inhibitors) may play a role in the difference between tobacco and nicotine dependence. Professor Susan Schenck (Victoria University) then presented her work on the regulation of serotonin and dopamine systems in the brain and the relationship to persistent drug taking.
Carina Walters (University of Auckland) provided some initial thoughts on her PhD work on over the counter and opioid prescription pain use. She highlighted the heterogeneity of users, the challenges of reporting prevalence and the accessibility of treatment. Blair Bishop (CCDHB) shared his qualitative findings of what it was like to receive suboxone for the treatment of opioid use disorder. Kirsten Gibson (Victoria University) discussed the stigma (whether that’s self/internalised stigma, social stigma or structural stigma) associated with the lives of women who inject drugs and the barrier that this generates in accessing harm reduction activities such as needle exchange programmes. Murray Wilson (Victoria University) talked of the downward social trajectory experienced prior to the onset of problematic drug use, in which the drug use becomes a coping mechanism or relief from the impact of stigma, exclusion and marginalisation, explaining how these insights led to the development of the NZ drug-users forum.
Associate Professor Jo Boden (University of Otago) opened the afternoon session by summarising some findings from the Christchurch Health and Development longitudinal study on the complex association between unemployment, cannabis use and alcohol misuse. Grahame Gee (Otago University/CCDHB) was inspired to investigate the risk of alcohol use among those with mild intellectual disabilities. The lack of research in this area led him to explore the choices made about alcohol consumption and how users are influenced by the multi-layered systems within which they live and their protective factors.
Karen Faisandier (Massey University/The Integrative Practice) presented her findings on treatment approaches for out-of-control sexual behaviour (OCSB), in particular issues of intimacy and attachment. Alexander Stevens (ASH/Indigenous Health Solutions) in his presentation entitled ‘Big boys don’t cry’ highlighted the sexual abuse that occurs against men and a model of intervention encompassed within a seasonal metaphor. Anne Macaskill (Victoria University) explained the complex opportunities created to win on slot machines and the impact that this had on ongoing and persistent gambling.
A focus on problem gambling
The afternoon session offered a wealth of knowledge and experience within the problem gambling research arena with presentations by Dr Maria Bellringer (AUT), Professor Chris Bullen (University of Auckland) and Professor Max Abbott (AUT). Maria summarised her findings from a randomised controlled trial showing long-term improvements of various structured gambling interventions compared to helpline standard care. Of note, regardless of the research treatment intervention offered, participants regularly sought additional support as required, indicating a self-selecting stepped-care approach. Chris talked about problem gambling and the utility of smartphone technology as a vehicle for receiving personalised interventions as an adjunct to treatment. This may be of particular value when noting the extent of smartphone ownership in New Zealand, particularly among Māori. In the final session of the day Max, being the ‘grandfather’ of gambling research, was able to quote himself noting that: “gambling like rust never sleeps, neither does the host nor society”. With the unprecedented expansion of legal, commercial gambling, associated harms follow although he also noted some pockets of problems plateauing. Reflecting on a plethora of research over many years he presented some interesting and sometimes controversial findings.
The breaks offered opportunities for networking and discussion, sharing ideas and findings among the established researchers, those new to the field and clinicians working in the addiction sector. They also provided the opportunity to view poster presentations that crossed a spectrum of topics including: opioid trends and access, electronic nicotine delivery systems, family access to methamphetamine treatment information, cocaine inhibitors, non-addictive pain medication, therapeutic community training evaluation and the drug interactions between alcohol and pharmaceutical medications.
More information and some of the presentations are available on the Matua Raki Addiction research page.