Dr Adrian Carter

Research Interests

Dr Adrian Carter is an NHMRC Research Fellow at The University of Queensland Centre for Clinical Research investigating the impact that neuroscience has on understanding and treatment of addiction and other compulsive behaviours. This includes the impact of neuroscience on: our notions of agency, identity and moral responsibility; the capacity for voluntary control of addictive or compulsive behaviours; coerced treatment of addictive disorders; and the use of emerging technologies, such as deep brain stimulation and brain imaging, to treat addiction.

Research Projects

Stakeholders' views of addiction neuroscience and its implications for treatment and public health policy: Neuroscience is revealing how addictive drugs act on the brain and why some individuals are more likely to develop addiction than others.  This research promises to change how society treats and thinks about addiction. There is optimism that neuroscience research will reduce stigma and improve access to treatment by demonstrating that addiction is a brain disease. In contrast, some critics have argued that neurobiological views of addiction exaggerate the difficulty in overcoming common forms of addiction, reduce drug users’ beliefs in their ability to achieve abstinence, and encourage the view that addiction can only be overcome by using pharmacological interventions. This research also has the potential to change the way that we think about and deal with “everyday addictions” such as food addiction and pathological gambling. This project will use qualitative and quantitative methods to answer the following questions:

  • How do neurobiological explanations of addiction affect people’s attitudes towards drug use and people with an addiction?
  • How does this research affect their ideas of personal responsibility and blame for drug use and criminal activity that may be engaged in to fund drug use? Does addiction neuroscience affect people’s support for the types of policies used to deal with addiction (e.g. coerced treatment of addiction, preventive vaccination of individuals at high risk of developing addiction, invasive neurosurgery)?
  • How do neurobiological explanations affect addicted individual’s understanding of themselves and their condition? Do they undermine their capacity and willingness to stop using drugs?

Project Funding:

ARC Discovery Project Grant ($143,624):  “‘A disease of the brain’: How do neurobiological explanations of addiction influence the attitudes and behaviour of smokers?”

MIND Foundation of British Columbia, Canada ($20,000): “Development of an evidence based rationale for delivering messages to the public to reduce stigma and discrimination.”

The University of Melbourne Interdisciplinary Seed Grant ($50,000): “Using addiction neuroscience to inform gambling research, treatment & policy”

NHMRC Postdoctoral Fellowship in Public Health, Grant No. 628935 ($285,000): “Translating addiction neuroscience into effective treatment and public policy”

Treatment-induced compulsive behaviours: Ethical and policy implications: Compulsive behaviours represent one of the largest preventable burdens in society. Some medications, such as those used to treat Parkinson’s disease, can produce severe compulsions in certain individuals, such as pathological gambling and hypersexuality. This project explores neurocognitive changes caused by these medications, the impact that drug-induced compulsive behaviours have on affected individuals, their sense of agency, identity and moral responsibility, and the ethical, legal and policy consequences of drug-induced behaviour. This study will help us to understand the neuropsychology of compulsive behaviour and reduce its occurrence. It will also enable society to meet the ethical and policy challenges raised by neuroscience research on compulsive behaviour.

Project Funding:

The University of Queensland Early Career Research Grant ($36,000): “Perspectives and experiences of Parkinson’s disease patients with drug-induced impulse control disorders: A qualitative study.”

Ethical and social barriers to contingency management programs to treat drug addiction: There is significant evidence that contingency management (e.g. financial incentives) are effective in reducing drug use and improving health outcomes. Some commentators have raised ethical concerns about the use of financial incentives to “nudge” behaviour toward healthy outcomes in vulnerable populations, such as those with drug addictions, where financial incentives may be seen as an unethical inducement. Others have questioned the long-term effectiveness of financial incentives arguing that they eliminate the moral worth of actions by placing a monetary value on them. This project will examine these ethical and empirical objections to contingency management programs in the treatment of drug addiction and other compulsive behaviours. There has also been relatively limited uptake of these programs. This study will examine addiction clinicians’ knowledge and use of contingency management approaches in treatment, and their attitudes towards them (e.g. effectiveness, appropriateness, willingness to use, barriers to implementation). The results of this study will lead to: a greater understanding of the barriers to implementing effective CM programs; the development of education and implementation programs for increasing CM uptake; identification of clinician concerns about the use of CM; and the development of novel research projects to develop CM programs that may overcome these concerns.

Project Funding:

The University of Queensland Start-up Grant ($11,600): “Clinician attitudes toward using contingency management programs to treat drug addiction.”

Review of the ethical use of emerging neurotechnologies to treat addiction: This project examines the potential ethical, social and public policy implications of technologies that have emerged or are likely to emerge from neurobiological research on addiction, their likely safety and effectiveness, and importantly, how they are likely to be used in society. These include: novel pharmacological treatments of addiction (e.g. anti-craving drugs), immunological blockades (drug vaccines) and sustained-release pharmacological preparations (drug implants); diagnostic technologies such as genetic screening and brain imaging to identify vulnerability to addiction and guide clinical decisions about treatment; and neurological technologies, such as neurosurgery and brain stimulation. This project will also consider some more speculative uses of neurotechnologies to identify and predict those who will develop addiction (e.g. using brain imaging to identify individuals at high risk of addiction and using “drug vaccines” to prevent these individuals from becoming addicted) or to enhance normal cognitive function.

Project Funding:

NHMRC Postdoctoral Fellowship in Public Health, Grant No. 628935 ($285,000): “Translating addiction neuroscience into effective treatment and public policy”

Key publications

Books

Carter, A., and Hall, W. (2012). Addiction neuroethics: The promises and perils of neuroscience research on addiction. London: Cambridge University Press.

Carter, A., Illes, J., and Hall, W. (Eds.). (2012). Addiction neuroethics: The ethics of addiction research and treatment. New York: Elsevier.

Journal Articles

Morphett, K., Lucke, J., Gartner, C., Carter, A., Meurk, C. and  Hall, W. (2013). Public attitudes towards the treatment of nicotine addiction. Nicotine & Tobacco Research (doi: 10.1093/ntr/ntt037).

Meurk, C., Carter, A., Hall, W. and Lucke, J. (2013). Public understandings of addiction: where do neurobiological explanations fit? Neuroethics (doi: 10.1007/s12152-013-9180-1).

Bell, S., Carter, A., Mathews, R., et al. (2013). Views of addiction neuroscientists and clinicians on the clinical impact of a ‘brain disease model of addiction'. Neuroethics (doi: 10.1007/s12152-013-9177-9).

Carter, A. and Hall, W. (2012). Ethical issues in research on craving. Addictive Behaviors, 38, 1593–1599.

Lee, N., Carter, A. and Hall, W. (2012). The neurobiology of overeating: What are the policy implications? EMBO Reports, 13, 785 – 790.

Carter, A. and Hall, W. (2012). Addiction may not be a compulsive brain disease, but it is more than purposeful medication of untreated psychiatric disorders. American Journal of Bioethics – Neuroscience, 3, 54-55.

Carter, A. and Hall, W. (2012). Avoiding selective ethical objections to nudges. American Journal of Bioethics, 12, 12-14.

Gartner, C., Carter, A. and Partridge, B. (2012). What are the public policy implications of a neurobiological view of addiction? Addiction, 107, 1199–200.

Mathews, R., Hall, W. and Carter, A. (2012). Direct-to-consumer genetic testing for addiction susceptibility: Premature commercialisation of genetic tests of doubtful validity and value. Addiction, 107, 2069–2074.

Ambermoon, P., Carter, A., Hall, W., et al. (2012). Compulsive use of dopamine replacement therapy: a model for stimulant drug addiction? Addiction, 107, 241-247.

Ambermoon, P., Carter, A., Hall, W. D., Dissanayaka, N. N. W., and O'Sullivan, J. D. (2011). Impulse control disorders in patients with Parkinson's disease receiving dopamine replacement therapy: evidence and implications for the addictions field. Addiction, 106, 2, 283-293.

Carter, A., and Hall, W. (2011). Proposals to trial deep brain stimulation to treat addiction are premature. Addiction, 106, 2, 235-237.

Hall, W., and Carter, A. (2011). Is Deep Brain Stimulation a prospective “cure” for addiction? F1000 Medicine Reports, 3, 4, doi:10.3410/M3413-3414.

Carter, A., and Hall, W. D. (2010). The need for more explanatory humility in addiction neurobiology. Addiction, 105, 5, 790-791.

Carter, A., and Hall, W. (2010). Beyond the right to injectable heroin. American Journal of Bioethics. 1, 1, 48-49.

Carter, A., Bell, E., Racine, E., and Hall, W. (2010). Ethical issues raised by proposals to treat addiction using deep brain stimulation. Neuroethics, DOI 10.1007/s12152-010-9091-3.

Carter, A., Ambermoon, P., and Hall, W. (2010). Drug-induced impulse control disorders: A prospectus for neuroethical analysis. Neuroethics, DOI: 10.1007/s12152-010-9071-7.

Carter, A., Bartlett, P., and Hall, W. (2009). Scare-mongering and the anticipatory ethics of experimental technologies. American Journal of Bioethics, 9, 5, 47-48.

Hall, W. D., Gartner, C. E., and Carter, A. (2008). The genetics of nicotine addiction liability: ethical and policy implications. Addiction. 103, 3, 350-359.

Hall, W., Capps, B., and Carter, A. (2008). The use of depot naltrexone under legal coercion: the case for caution. Addiction. 103, 1922-1924.

Carter, A., and Hall, W. (2008). The issue of consent to research that administers drugs of addiction to addicted persons. Accountability in Research. 15, 209-225.

Carter, A., and Hall, W. (2008). Informed consent to opioid agonist maintenance treatment: Recommended ethical guidelines. International Journal of Drug Policy. 19, 1, 79-89.

Book Chapters

Hall, W., Carter, A. and Yucel, M. (in press). Ethical issues in the neuroprediction of addiction risk and treatment response. In N. Levy and J. Clausen (Eds.), Handbook of Neuroethics. Heidelberg: Springer. (Accepted: 22 March, 2013).

Hall, W. and Carter, A. (in press). A history of drug use in Australia. In M. Hamilton, A. Ritter and T. King (Eds.), Drug Use in Society. London: Oxford University Press. (Accepted: 17 August 2012).

Carter, A. and Hall, W. (2013). Addiction Neuroethics: Ethical and Social Implications of Genetic and Neuroscience Research on Addiction Biological Research on Addiction:Comprehensive Addictive Behaviors and Disorders (pp. 541–549). San Diego: Academic Press.

Carter, A. and Hall, W. (2013). Ethical Issues in the Treatment of Drug Dependence Interventions for Addiction:Comprehensive Addictive Behaviors and Disorders (pp. 611–620). San Diego: Academic Press.

Hall, W. and Carter, A. (2013). How may neuroscience affect the way that the criminal courts deal with addicted offenders? In N. Vincent (Ed.), Neuroscience and Responsibility (pp. 279-302). London: Oxford University.

Carter, A., Hall, W., and Miller, P. (2012). The ethics of harm reduction. In R. Pates (Ed.), Harm Reduction in Substance Use and High-Risk Behaviour (pp. 111-23) London: Wiley Blackwell.

Carter, A., and Hall, W. (2012). The rights of individuals treated for addiction. In D. Dudley, D. Silove and F. Gale (Eds.), Mental Health and Human rights. (pp. 519-29). London: Oxford University Press.

Carter, A., Hall, W. and Illes, J. (2012). What is addiction neuroethics and why does it matter? In A. Carter, W. Hall and J. Illes (Eds.), Addiction neuroethics: The ethics of addiction research and treatment (pp. xvii-xxv). New York: Elseveir.

Carter, A., Capps, B., and Hall, W. (2012). Emerging neurobiological treatments of addiction: Ethical and public policy considerations. In A. Carter, W. Hall and J. Illes (Eds.), Addiction neuroethics: The ethics of addiction research and treatment (pp. 96-115). New York: Elseveir.

Miller, P., Carter, A. and De Groot, F. (2012). Investment and vested interests in neuroscience research of addiction: Why research ethics requires more than consent. In A. Carter, W. Hall and J. Illes (Eds.), Addiction neuroethics: The ethics of addiction research and treatment (pp. 278-301). New York: Elseveir.

Government Reports

Carter, A., Capps, B., Nutt, D., et al. (2009). Addiction Neurobiology: Ethical and Social Implications. Lisbon: European Monitoring Centre for Drugs and Drug Addiction. http://www.emcdda.europa.eu/publications/monographs/neurobiology

Carter, A., Hall, W., Capps, B., and Daglish, M. (2009). Neurobiological research on addiction: Review of the Scientific, Public Health and Social Policy Implications for Australia. Sydney: Ministerial Council on Drugs. http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/neu-res-add.

Carter, A., and Hall, W. (2007). The Ethical Use of Psychosocially Assisted Pharmacological Treatment of Opioid Dependence. Geneva: World Health Organization.http://www.who.int/substance_abuse/activities/ethical_use_opioid_treatment.pdf

Contact details and email

Dr. Adrian Carter

NHMRC Postdoctoral Fellow

UQ Centre for Clinical Research

The University of Queensland

Herston QLD 4029

p +61-7-3346-5474

f +61-7-3346-5598

e adrian.carter@uq.edu.au

w:/neuroethics

t: @NeuroethicsUQ

Funding acknowledgement

NHMRC, ARC, UQ, Mind Foundation (BC, Canada), University of Melbourne, World Health Organization, European Monitoring Centre for Drugs and Drug Addiction, Ministerial Council on Drug Strategy

Technique Expertise

Qualitative research methods

Ethical and policy analysis

Neuropsychological testing

Research Team

Dr Nadeeka Dissanayaka (Lions Research Fellow)

Natalia Lee (Masters of Public Health Student)

Katie Lineberg (Masters of Science Communication Student)

Peter Bell (Research Assistant)

 

Collaborations

Professor Judy Illes (Chair, National Core for Neuroethics, University of British Columbia, Canada)

Dr Peter Reiner (National Core for Neuroethics, University of British Columbia, Canada)

Professor Murat Yücel (Monash Clinical and Imaging Neuroscience (MCIN) Laboratory)

Associate Professor John O’Sullivan (Neurology, Royal Brisbane and Women’s Hospital)

Dr Nadeeka Dissanayaka (University of Queensland Centre for Clinical Research)

Assistant Prof Benjamin Capps (Centre for Biomedical Ethics, National University of Singapore)

Dr Mark Daglish (Director, Addiction Psychiatry, UQ and Hospital Alcohol and Drugs Service)

Dr Christian Rowan (Director of Medical Services, St Andrew’s War Memorial Hospital)

Dr Francesca Bartlett (School of Law, University of Queensland)

Dr Joan Leach, Convenor (Science Communication, University of Queensland)

Associate Professor Peter Miller (School of Psychology, Deakin University)

Recognition

Dr Carter received the Australasian Professional Society of Alcohol and Other Drugs “Early Career Award for Excellence in Research and Science” (2012), the Australian National Drug and Alcohol Award for Excellence in Research (2010) and the University of Queensland Dean’s Award for Outstanding Research Higher Degree Theses (2010). He has published two books, including ‘Addiction Neuroethics: The Promises and Perils of Addiction Neuroscience’ (Cambridge University Press, 2012). Dr Carter has over 70 publications, including reports for the World Health Organization (WHO), the European Monitoring Centre for Drugs and Drug Addiction, and the Australian Ministerial Council on Drugs Strategy. He has been an advisor to the WHO and United Nations Office on Drugs and Crime (UNODC) on the use of coercion in drug treatment and the ethical treatment of opioid dependence.