Adolescence and young adulthood (12-25 years of age) are periods of marked risk for the development of substance use disorders (SUDs) with 75% of all cases developing before the age of 25.

For some, the SUD develops as a result of repeated use in an attempt to self-medicate underlying trauma and symptoms of post-traumatic stress disorder (PTSD) which also has its peak age of onset during these formative years. Although substance use may help in managing these symptoms in the short term, repeated use complicates recovery and can lead to a more chronic course of illness with each disorder serving to maintain and exacerbate the other. 

There is a need to intervene early in the trajectory of these disorders to prevent chronic psychological, neurological and physical health problems that may result and persist into adulthood. The need for scalable interventions for high-risk young people has been amplified by the cumulative stressors of recent years (i.e, catastrophic bushfires, floods, and the COVID-19 pandemic) that have disproportionally affected our young people and led to significant strain on in-person service delivery. 

Building on the findings of our pioneering NHMRC funded trials demonstrating the efficacy of integrated psychotherapies for SUD+PTSD ( COPE for adults and COPE-A for adolescents and young people) we are conducting a randomised controlled trial to examine the efficacy of delivering COPE-A to adolescents and young people in-person and via telehealth. By intervening early and addressing underlying trauma we have the potential to reduce the enduring disability, personal and societal costs associated with SUD. 

Australian New Zealand Clinical Trials Register registation number: ACTRN12624000776505

Anxiety and alcohol use disorders are among the most common mental health disorders world-wide. Anxiety is particularly common during emerging adulthood, when young people go through significant life changes.

During this time, it is common for young people to use alcohol as a way of coping with their anxiety, which can paradoxically make anxiety worse. For instance, drinking to feel less anxious in the moment can lead to an over-reliance on alcohol, and the consequences of drinking, like withdrawal and feelings of shame or guilt, can end up causing even more anxiety in the long term.

The Inroads program is an online, early intervention program for young adults with anxiety symptoms who drink alcohol at hazardous levels. The program involves 5 self-guided modules, developed in collaboration with youth, that provide evidence-based strategies (e.g., cognitive behavioural therapy) for managing anxiety and setting limits around drinking.

A randomised controlled trial of the program showed that youth who received the Inroads program, in combination with low-intensity psychologist support, experienced greater reductions in hazardous drinking, general anxiety and social anxiety compared to a control group. 

We are currently recruiting participants for a larger NHMRC-funded trial of the program, and are working with international partners to develop a Canadian adaptation of the program.

Heroin dependence is a remarkably persistent, and in many cases, lifelong condition with a high mortality rate. Yet, there is much about heroin dependence – especially over the long-term – that we do not understand. 

Funded by the NHMRC, ATOS began in 2001-2002 by recruiting 615 people, who we have followed up six times, up to 18-20-years. In doing so, this landmark study is the largest and longest cohort study conducted in Australia and provides critical information that will better inform treatment and guide public health responses. 

Population estimates indicate that more than one-third of people with an alcohol or other drug (AOD) use disorder have at least one co-occurring mental disorder, with rates even higher among those in AOD treatment programs. It is therefore critical that AOD workers are able to manage the complex psychiatric symptoms with which their clients frequently present.

Funded by the Australian Government Department of Health and Aged Care, the Comorbidity Project has developed a range of evidence-based resources that aim to improve the capacity of the AOD workforce to respond to co-occurring mental health conditions.

Based on the best available research evidence, resources have been developed in consultation with key stakeholders, including clinicians, researchers, people with lived experience, families and carers.

Resources include clinical guidelines for the AOD workforce, online training, skills-based training, train-the-trainer workshops, a community of practice and national practice standards for the alcohol and other drug sector.

Alcohol and other drug (AOD) use can play a significant role in the development and maintenance of mental health conditions and dramatically impact treatment outcomes.

Despite the high prevalence and impact of AOD use and use disorders, they often go unidentified and untreated in mental health settings, with few evidence-based resources available to the mental health sector to help guide clinical decision-making.

Funded by the Australian Government Department of Health and Aged Care, these Guidelines will be based on the best available evidence and developed in close consultation with practitioners, people with lived experience, family members and loved ones.

This resource aims to build the capacity of the mental health workforce to identify and respond to co-occurring AOD use of varying levels of severity, improve treatment outcomes and support people’s long-term recovery.