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Journal of Substance Abuse Treatment

Steven L Proctor, Jaclyn L Wainwright, Philip L Herschman, Albert M Kopak
BACKGROUND & OBJECTIVE: Substance use disorder treatments are increasingly being contextualized within a disease management framework. Within this context, there is an identified need to maintain patients in treatment for longer periods of time in order to help them learn how to manage their disease. One way to meet this need is through telephone-based interventions that engage patients, and include more active outreach attempts and involvement of the patient's family. This study sought to evaluate the effectiveness of three formats of an intensive 12-month post-discharge telephone-based case management approach (AiRCare) on adherence to continuing care plans and substance use outcomes...
February 2017: Journal of Substance Abuse Treatment
Mehmet Sofuoglu, James Poling, Theresa Babuscio, Kishorchandra Gonsai, Kevin Severino, Charla Nich, Kathleen M Carroll
INTRODUCTION: The goal of this study was too test the efficacy of carvedilol (CAR), an adrenergic blocker, for reducing cocaine use in individuals with cocaine use disorder (CUD). We conducted a 17-week, double-blind, randomized controlled trial with 3 treatment arms: 25mg CAR, 50mg CAR, and placebo. METHODS: One hundred and six treatment-seeking opioid and cocaine-dependent participants, who were also maintained on methadone during study participation, were randomized to placebo (n=34), 25mg/day CAR (n=37) or 50mg/day CAR (n=35)...
February 2017: Journal of Substance Abuse Treatment
Dennis G Fisher, Grace L Reynolds, Laura H D'Anna, David W Hosmer, Kholoud Hardan-Khalil
Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4...
February 2017: Journal of Substance Abuse Treatment
Scott P Stumbo, Bobbi Jo H Yarborough, Dennis McCarty, Constance Weisner, Carla A Green
BACKGROUND: Risk factors associated with developing opioid use disorders (OUD) are documented, but less is known about different pathways to initiation of opioids or opioid dependence, or how such pathways affect treatment engagement. METHODS: We recruited 283 adults with electronic medical record (EMR) evidence of opioid dependence diagnoses. Open-ended and structured interview items focused on prior opioid treatment experiences, barriers to and knowledge of treatment options...
February 2017: Journal of Substance Abuse Treatment
Barbara K Campbell, Thao Le, Barbara Tajima, Joseph Guydish
Although individuals in substance use disorders (SUD) treatment continue to smoke at high rates, regulatory, policy and programming changes promoting tobacco cessation are being implemented and some patients quit successfully. We examined associations of smoking patterns, tobacco advertising receptivity, anti-tobacco message awareness, health risk perception, attitudes towards addressing smoking and availability of smoking cessation services with quitting smoking during SUD treatment. Surveys were completed by 1127 patients in 24 programs chosen randomly, stratified by program type (residential, methadone maintenance, outpatient), from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network...
February 2017: Journal of Substance Abuse Treatment
Susan E Mackie, R Kathryn McHugh, Katherine McDermott, Margaret L Griffin, John W Winkelman, Roger D Weiss
BACKGROUND AND AIMS: Restless legs syndrome (RLS) is a movement disorder associated with adverse health outcomes and decreased quality of life. Small case series suggest that symptoms of RLS occur during opioid withdrawal. However, the prevalence is unknown. METHODS: We conducted an observational study to determine the prevalence of RLS among inpatients patients receiving buprenorphine detoxification from opioids. To assess the specificity of RLS to opioid detoxification, we also evaluated patients receiving detoxification from alcohol as a comparison group...
February 2017: Journal of Substance Abuse Treatment
Kara M Bensley, Alex H S Harris, Shalini Gupta, Anna D Rubinsky, Rhonda Jones-Webb, Joseph E Glass, Emily C Williams
OBJECTIVE: Specialty addictions treatment can improve outcomes for patients with alcohol use disorders (AUD). Thus, initiation of and engagement with specialty addictions treatment are considered quality care for patients with AUD. Previous studies have demonstrated racial/ethnic differences in alcohol-related care but whether differences exist in initiation of and engagement with specialty addictions treatment among patients with clinically recognized alcohol use disorders is unknown...
February 2017: Journal of Substance Abuse Treatment
Sarah E Zemore, Lee Ann Kaskutas, Amy Mericle, Jordana Hemberg
BACKGROUND: Many studies suggest that participation in 12-step groups contributes to better recovery outcomes, but people often object to such groups and most do not sustain regular involvement. Yet, research on alternatives to 12-step groups is very sparse. The present study aimed to extend the knowledge base on mutual help group alternatives for those with an alcohol use disorder (AUD), sampling from large, active, abstinence-focused groups including Women for Sobriety (WFS), LifeRing, and SMART Recovery (SMART)...
February 2017: Journal of Substance Abuse Treatment
Brian Borsari, Timothy R Apodaca, Ali Yurasek, Peter M Monti
Motivational interviewing (MI) is often incorporated into screening, brief intervention, and referral to treatment (SBIRT) interventions in critical care settings to address alcohol and other drug use. However, cognitive status has been linked to differential response to MI sessions in emergency department (ED) settings. The current study examined one possible explanation for this differential response: whether higher versus lower mental status impacts patient response to clinician statements during MI sessions conducted in an ED...
February 2017: Journal of Substance Abuse Treatment
Steven Shoptaw, Raphael J Landovitz, Cathy J Reback
Stimulant use rates are higher among men who have sex with men (MSM) than the general population. Contingency management (CM) may be an effective intervention for reducing stimulant use in this population. To specify both the mechanism and temporal effects of contingent reward on behavior change, logistic growth trajectory modeling (LGTM) was used to contrast a non-contingent matched rewards condition (i.e., non-contingent yoked controls; NCYC) to a voucher-based CM intervention (maximum=$430) to reduce stimulant use among MSM...
January 2017: Journal of Substance Abuse Treatment
Hannah K Knudsen
No abstract text is available yet for this article.
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: 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...
January 2017: Journal of Substance Abuse Treatment
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