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Journal of Substance Abuse Treatment

Carla J Rash, Maxine Stitzer, Jeremiah Weinstock
This article introduces the special issue on contingency management (CM), an efficacious intervention for the treatment of substance use disorders with low uptake in clinical settings that is not commensurate with evidence for efficacy. In this special issue of the Journal of Substance Abuse Treatment, we present 16 articles representing the latest research in efficacy, implementation, and technological advances related to CM. Combined, this collection of articles highlights the diverse populations, settings, and applications of CM in the treatment of substance use disorders...
September 28, 2016: Journal of Substance Abuse Treatment
Mary Brolin, Maria Torres, Dominic Hodgkin, Constance Horgan, Margaret Lee, Elizabeth Merrick, Grant Ritter, Lee Panas, Natasha DeMarco, Jonna Hopwood, Andrea Gewirtz, John Straus, Janice Harrington, Nancy Lane
OBJECTIVE: Multiple detoxification admissions among clients with substance use disorders (SUD) are costly to the health care system. This study explored the impact on behavior and cost outcomes of recovery support navigator (RSN) services delivered with and without a contingent incentive intervention. METHODS: New intakes at four detoxification programs were offered RSN-only (N=1116) or RSN plus incentive (RSN+I; N=1551) services. The study used a group-level cross-over design with the intervention in place at each clinic reversed halfway through the enrollment period...
September 12, 2016: Journal of Substance Abuse Treatment
Michelle Tuten, Julia M Shadur, Maxine Stitzer, Hendrée E Jones
OBJECTIVES: Reinforcement-based treatment (RBT) plus recovery housing (RBT(RH)) improves outcomes for individuals with opioid use disorders. No studies have examined the efficacy of RBT in the absence of abstinent-contingent housing. METHODS: We compared highly similar participants from a study of outpatient RBT (RBT, n=55) and the RBT(RH) (n=80) arm of a randomized trial wherein participants received abstinent-contingent payment for recovery housing sponsored by the research program...
September 10, 2016: Journal of Substance Abuse Treatment
Jeremiah Weinstock, Margaret R Farney, Noel M Elrod, Craig E Henderson, Edward P Weiss
Substance use disorders (SUDs) are maladaptive patterns of substance use that are associated with psychiatric comorbidity, unhealthy lifestyle choices, and high rates of relapse. Exercise is associated with a wide range of acute and long-term benefits for both mental and physical health and is presently being investigated as a promising adjunctive treatment for SUD. Despite positive effects of regular physical activity on treatment outcomes and risk factors for relapse, low adherence and high attrition rates limit the benefits derived from exercise interventions...
September 9, 2016: Journal of Substance Abuse Treatment
Margaret C Wardle, Jessica N Vincent, Robert Suchting, Charles E Green, Scott D Lane, Joy M Schmitz
This study explored anhedonia (lack of interest or pleasure in non-drug rewards) as a potentially modifiable individual difference associated with the effectiveness of Contingency Management (CM). It also tested the hypothesis that a dopaminergic drug, levodopa (L-DOPA), would improve the effectiveness of CM, particularly in individuals high in anhedonia. The study was a single-site, randomized, double-blind, parallel group, 12-week trial comparing L-DOPA with placebo, with both medication groups receiving voucher-based CM targeting cocaine-negative urines...
September 9, 2016: Journal of Substance Abuse Treatment
Elizabeth J Letourneau, Michael R McCart, Ashli J Sheidow, Pia M Mauro
There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents...
August 31, 2016: Journal of Substance Abuse Treatment
Maxine Stitzer, Donald Calsyn, Timothy Matheson, James Sorensen, Lauren Gooden, Lisa Metsch
Contingency management (CM) interventions generally target a single behavior such as attendance or drug use. However, disease outcomes are mediated by complex chains of both healthy and interfering behaviors enacted over extended periods of time. This paper describes a novel multi-target contingency management (CM) program developed for use with HIV positive substance users enrolled in a CTN multi-site study (0049 Project HOPE). Participants were randomly assigned to usual care (referral to health care and SUD treatment) or 6-months strength-based patient navigation interventions with (PN+CM) or without (PN only) the CM program...
August 28, 2016: Journal of Substance Abuse Treatment
Damaris J Rohsenow, Rosemarie A Martin, Jennifer W Tidey, Suzanne M Colby, Peter M Monti
: Treatment for substance use disorders (SUD) provides an opportunity to use voucher-based treatment for smoking. Nicotine replacement (NRT) could improve outcomes previously observed with vouchers without NRT. METHODS: A randomized controlled trial compared contingent vouchers (CV) for smoking abstinence to noncontingent vouchers (NV), when all received counseling and NRT. Smokers who had not sought smoking treatment (n=340) in residential SUD treatment were provided 14days of vouchers for complete smoking abstinence per exhaled carbon monoxide (CO) after a 5-day smoking reduction period, or vouchers only for breath samples, plus brief advice (four sessions) and 8weeks of NRT...
August 18, 2016: Journal of Substance Abuse Treatment
Brian D Kiluk, Matthew B Buck, Kathleen A Devore, Theresa A Babuscio, Charla Nich, Kathleen M Carroll
Impairments in attention, working memory, and executive function are common among substance users and may adversely affect SUD treatment outcomes. The ability of cognitive remediation (CR) interventions to improve these deficits is hindered in part because levels of engagement in CR training may be inadequate to achieve benefit. This pilot study aimed to increase CR engagement and improve outcome by implementing contingency management (CM) procedures that reinforce performance improvements on CR tasks. Participants were forty individuals (50% male; 65% African American) in an outpatient substance use treatment facility with mild cognitive impairment who had ≥30-days of abstinence from alcohol and drugs...
August 10, 2016: Journal of Substance Abuse Treatment
Kelly E Dunn, Frederick S Barrett, Claudia Yepez-Laubach, Andrew C Meyer, Bryce J Hruska, Kathy Petrush, Suzan Berman, Stacey C Sigmon, Michael Fingerhood, George E Bigelow
BACKGROUND: Opioid use is highly prevalent in the United States and there has been an increased incidence in the rate of opioid-related overdose. While evidence suggests there are substantial differences in opioid use among rural versus urban settings, the rate of overdose and corresponding frequency of opioid overdose risk behaviors and overdose knowledge between rural and urban settings have not been examined. METHODS: Individuals with opioid use disorder from rural (N=98) and urban (N=247) settings completed a self-report survey regarding their lifetime history of overdose and overdose risk behaviors...
December 2016: Journal of Substance Abuse Treatment
Michael Kidorf, Carl Latkin, Robert K Brooner
The present study evaluated the presence of drug-free family and friends in the personal social networks of individuals seeking treatment for opioid use disorder, and the willingness of patients to bring these individuals to the treatment program to support recovery efforts. Patients at a community medication-assisted treatment program (n=355) completed a clinical survey to identify drug-free social network members. Results showed that almost all patients (98%) reported having at least one drug-free family or friend in their personal network (M=3...
November 2016: Journal of Substance Abuse Treatment
Bennett Allen, Alex Harocopos
Non-medical use of opioid analgesics (OAs) has increased in the United States over the past decade. Concurrently, access to opioid agonist therapies (OATs) such as buprenorphine has expanded. However, there has been little in-depth qualitative exploration into circumstances surrounding buprenorphine diversion and non-prescribed use. This study reports on qualitative data from in-depth interviews conducted with persons in New York City reporting non-medical OA use in the past 12 months. Participants (n=42) were aged between 18 and 49 years...
November 2016: Journal of Substance Abuse Treatment
Robert Lindblad, Lian Hu, Neal Oden, Paul Wakim, Carmen Rosa, Paul VanVeldhuisen
BACKGROUND: Most substance use disorders (SUD) treatment clinical trials are too short and small to reliably estimate the incidence of rare events like death. OBJECTIVE: The aim of this study is to estimate the overall mortality rates among a SUD treatment-seeking population by pooling participants from multiple clinical trials conducted through the National Institute on Drug Abuse (NIDA)-sponsored National Drug Abuse Treatment Clinical Trials Network (CTN). PARTICIPANTS: Drug and or alcohol users (N=9866) who sought treatment and participated in one of the twenty-two CTN trials...
November 2016: Journal of Substance Abuse Treatment
Nathan J Doogan, Keith Warren
BACKGROUND: Therapeutic community (TC) clinical theory assumes that peer interaction forms a framework for social learning that will displace ingrained cognitive schema that underlie substance abuse. There has been no direct test of this hypothesis. METHODS: We analyzed the content of a large corpus of written affirmations (pushups) and corrections (pull-ups) exchanged between 2342 male TC graduates. We encoded the content of the written communications as semantic networks of words, in which words that appear in the same brief document are connected and are referred to as word combinations...
November 2016: Journal of Substance Abuse Treatment
Christine Timko, Nicole R Schultz, Jessica Britt, Michael A Cucciare
Although successful transitions from detoxification to substance use disorder treatment are associated with improved outcomes, many detoxification patients do not initiate treatment. This qualitative study informs detoxification and addiction treatment providers, and health systems, about how to improve detoxification to treatment transitions, by reporting detoxification providers' views of transition facilitators and barriers. The sample consisted of 30 providers from 30 Veterans Health Administration detoxification programs...
November 2016: Journal of Substance Abuse Treatment
Sarah Larney, Wilson Lai, Kate Dolan, Deborah Zador
BACKGROUND AND AIMS: Opioid substitution therapy (OST) is an effective treatment for opioid dependence that is provided in many correctional settings, including New South Wales (NSW), Australia. In 2011, changes to the clinical governance of the NSW prison OST program were implemented, including a more comprehensive assessment, additional specialist nurses, and centralization of program management and planning. This study aimed to document the NSW prison OST program, and assess the impact of the enhanced clinical governance arrangements on retention in treatment until release, the provision of an OST prescription to patients at release, and presentation to a community OST clinic within 48 hours of release from custody...
November 2016: Journal of Substance Abuse Treatment
Paul Crits-Christoph, Hannah M Markell, Mary Beth Connolly Gibbons, Robert Gallop, Christie Lundy, Mark Stringer, David R Gastfriend
The purpose of this study was to compare the naturalistic outcomes of individuals with alcohol or opioid use problems who were treated with extended-release naltrexone (XR-NTX) to those treated with psychosocial treatment only and also to those treated with other medication-assisted therapies in Missouri during 2010 to 2011. We analyzed intake and discharge data collected as part of SAMHSA's Treatment Episode Data Set assessments. Patients who received XR-NTX during their treatment episode were compared, for those reporting alcohol (but not opioids) as their problem (N=21,137), to those who received oral naltrexone, acamprosate, and psychosocial treatment only, and for those who reported opioids as a problem (N=8996), to those receiving oral naltrexone, buprenorphine/naloxone, and psychosocial treatment only...
November 2016: Journal of Substance Abuse Treatment
Lisa Zubkoff, Brian Shiner, Bradley V Watts
INTRODUCTION: Guidelines recommend that substance use disorder (SUD) treatment be available in primary care-mental health integrated clinics, which offer mental and behavioral health assessment and treatment in the primary care setting. Despite this recommendation it is unclear what barriers and facilitators exist to SUD treatment being provided in that setting. This work sought to understand current SUD services in such integrated clinics, explore other services may that be appropriate, and identify barriers to such services...
November 2016: Journal of Substance Abuse Treatment
Cary J Blum, Lewis S Nelson, Robert S Hoffman
BACKGROUND: Prescription drug monitoring programs (PDMPs) have emerged as one tool to combat prescription drug misuse and diversion. New York State mandates that prescribers use its PDMP (called ISTOP) before prescribing controlled substances. We surveyed physicians to assess their experiences with mandatory PDMP use. METHODS: Electronic survey of attending physicians, from multiple clinical specialties, at one large urban academic medical center. RESULTS: Of 207 responding physicians, 89...
November 2016: Journal of Substance Abuse Treatment
M Magill, Timothy R Apodaca, Justin Walthers, Jacques Gaume, Ayla Durst, Richard Longabaugh, Robert L Stout, Kathleen M Carroll
The present work provides an overview, and pilot reliability and validity for the Alcohol Intervention Mechanisms Scale (AIMS). The AIMS measures therapist interventions that occur broadly across modalities of behavioral treatment for alcohol use disorder. It was developed based on identified commonalities in the function rather than content of therapist interventions in observed therapy sessions, as well as from existing observer rating systems. In the AIMS, the primary function areas are: explore (four behavior count codes), teach (five behavior count codes), and connect (three behavior count codes)...
November 2016: Journal of Substance Abuse Treatment
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