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Addiction Science & Clinical Practice

Alex H S Harris, Thomas Bowe, Hildi Hagedorn, Andrea Nevedal, Andrea K Finlay, Risha Gidwani, Craig Rosen, Chad Kay, Melissa Christopher
BACKGROUND: Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. METHODS: An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate...
September 15, 2016: Addiction Science & Clinical Practice
(no author information available yet)
No abstract text is available yet for this article.
2016: Addiction Science & Clinical Practice
Karen Chan Osilla, David P Kennedy, Sarah B Hunter, Ervant Maksabedian
BACKGROUND: Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors. METHODS: We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds of beta testing...
2016: Addiction Science & Clinical Practice
Anna E Ordóñez, Rachel Ranney, Maxine Schwartz, Carol A Mathews, Derek D Satre
BACKGROUND: Alcohol use can have a significant negative impact on young adults in mental health treatment. This cross-sectional study examined prevalence and factors associated with hazardous drinking among young adults seeking outpatient mental health services, rate of alcohol use disorders (AUDs), and the relationship between hazardous drinking and other types of substance use. METHODS: Participants were 487 young adults ages 18-25 who completed self-administered computerized screening questions for alcohol and drug use...
2016: Addiction Science & Clinical Practice
Sigmund J Kharasch, David R McBride, Richard Saitz, Ward P Myers
BACKGROUND: In 2009, a university adopted a policy of emergency department transport of students appearing intoxicated on campus. The objective was to describe the change in ED referrals after policy initiation and describe a group of students at risk for acute alcohol-related morbidity. METHODS: A retrospective cohort of university students during academic years 2007-2011 (September-June) transported to local ED's was evaluated. Data were compared 2 years prior to initiation of the policy and 3 years after and included total number of ED transports and blood or breath alcohol level...
2016: Addiction Science & Clinical Practice
Natalia Gnatienko, Steve C Han, Evgeny Krupitsky, Elena Blokhina, Carly Bridden, Christine E Chaisson, Debbie M Cheng, Alexander Y Walley, Anita Raj, Jeffrey H Samet
BACKGROUND: Russia and Eastern Europe have one of the fastest growing HIV epidemics in the world. While countries in this region have implemented HIV testing within addiction treatment systems, linkage to HIV care from these settings is not yet standard practice. The Linking Infectious and Narcology Care (LINC) intervention utilized peer-led strengths-based case management to motivate HIV-infected patients in addiction treatment to obtain HIV care. This paper describes the protocol of a randomized controlled trial evaluating the effectiveness of the LINC intervention in St...
2016: Addiction Science & Clinical Practice
Gustavo A Angarita, Nazli Emadi, Sarah Hodges, Peter T Morgan
Sleep abnormalities are associated with acute and chronic use of addictive substances. Although sleep complaints associated with use and abstinence from addictive substances are widely recognized, familiarity with the underlying sleep abnormalities is often lacking, despite evidence that these sleep abnormalities may be recalcitrant and impede good outcomes. Substantial research has now characterized the abnormalities associated with acute and chronic use of alcohol, cannabis, cocaine, and opiates. This review summarizes this research and discusses the clinical implications of sleep abnormalities in the treatment of substance use disorders...
2016: Addiction Science & Clinical Practice
Jaclyn E Chambers, Adam C Brooks, Rachel Medvin, David S Metzger, Jennifer Lauby, Carolyn M Carpenedo, Kevin E Favor, Kimberly C Kirby
BACKGROUND: Brief interventions such as Screening, a single session of Brief Intervention, and Referral to Treatment (SBIRT) have shown mixed effectiveness in primary care. However, there are indications that multi-session brief interventions may demonstrate more consistently positive outcomes, and perhaps a more intensive approach would be of benefit in addressing substance use in primary care. This study compared the effectiveness of SBIRT with a single BI session (BI/RT) to a multi-session brief-treatment intervention (BI/RT+) in primary care...
2016: Addiction Science & Clinical Practice
Eric R Pedersen, Grant N Marshall, Terry L Schell
BACKGROUND: Young adult veterans from the wars in Iraq and Afghanistan represent a population at-risk for heavy and problematic alcohol use. Unfortunately, few seek treatment for alcohol concerns and those that do seek care may drop out from lengthy multicomponent treatments. Additionally, veterans who live in rural areas and those who are not engaged in the Veterans Affairs Healthcare System are often overlooked, difficult to engage in treatment, and may not be actively seeking treatment for heavy patterns of use that may develop into an alcohol use disorder...
2016: Addiction Science & Clinical Practice
Karen Chan Osilla, Katherine E Watkins, Magdalena Kulesza, Karen Flórez, Marielena Lara-Greenberg, Jeremy N V Miles
BACKGROUND: Driving under the influence (DUI) of alcohol is a major public health concern, and many individuals continue to drink and drive even after being convicted of a DUI offense. Latinos, in particular, are disproportionately likely to be arrested for a DUI, have higher rates of recidivism, and are more likely to die in alcohol-related accidents than non-Latino Whites. Latinos also experience significant disparities in accessing alcohol-related treatment. METHODS/DESIGN: This study protocol paper describes a randomized trial of cognitive behavioral therapy (CBT) compared to usual care in DUI programs for individuals with a first-time offense and at-risk drinking...
2016: Addiction Science & Clinical Practice
Jeffrey H Samet
No abstract text is available yet for this article.
2016: Addiction Science & Clinical Practice
David P Kennedy, Sarah B Hunter, Karen Chan Osilla, Ervant Maksabedian, Daniela Golinelli, Joan S Tucker
BACKGROUND: Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. METHODS/DESIGN: In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition...
2016: Addiction Science & Clinical Practice
William C Becker, Jessica S Merlin, Ajay Manhapra, Ellen L Edens
BACKGROUND: Patients, providers, communities and health systems have struggled to achieve balance between access to opioid treatment for chronic pain and its potential harmful consequences: especially misuse, addiction and overdose. We developed an interdisciplinary clinic embedded within primary care (the Opioid Reassessment Clinic-ORC) with the goal of improving the quality of care of patients with co-occurring chronic pain and issues related to opioid safety, efficacy and/or misuse...
2016: Addiction Science & Clinical Practice
Bryan Hartzler, K Michelle Peavy, T Ron Jackson, Molly Carney
BACKGROUND: Pragmatic trials of empirically-supported behavior therapies may inform clinical and policy decisions concerning therapy sustainment. This retrospective trial design paper describes and discusses pragmatic features of a hybrid type III implementation/effectiveness trial of a contingency management (CM) intervention at an opioid treatment program. Prior reporting (Hartzler et al., J Subst Abuse Treat 46:429-438, 2014; Hartzler, Subst Abuse Treat Prev Policy 10:30, 2015) notes success in recruiting program staff for voluntary participation, durable impacts of CM training on staff-level outcomes, provisional setting implementation of the intervention, documentation of clinical effectiveness, and post-trial sustainment of CM...
2016: Addiction Science & Clinical Practice
E Jennifer Edelman, Nathan B Hansen, Christopher J Cutter, Cheryl Danton, Lynn E Fiellin, Patrick G O'Connor, Emily C Williams, Stephen A Maisto, Kendall J Bryant, David A Fiellin
BACKGROUND: Effective counseling and pharmacotherapy for unhealthy alcohol use are rarely provided in HIV treatment settings to patients. Our goal was to describe factors influencing implementation of a stepped care model to address unhealthy alcohol use in HIV clinics from the perspectives of social workers, psychologists and addiction psychiatrists. METHODS: We conducted two focus groups with Social Workers (n = 4), Psychologists (n = 2), and Addiction Psychiatrists (n = 4) involved in an ongoing randomized controlled trial evaluating the effectiveness of integrated stepped care for unhealthy alcohol use in HIV-infected patients at five Veterans Health Administration (VA) HIV clinics...
2016: Addiction Science & Clinical Practice
Jennifer R Mertens, Felicia W Chi, Constance M Weisner, Derek D Satre, Thekla B Ross, Steve Allen, David Pating, Cynthia I Campbell, Yun Wendy Lu, Stacy A Sterling
BACKGROUND: Unhealthy alcohol use is a major contributor to the global burden of disease and injury. The US Preventive Services Task Force has recommended alcohol screening and intervention in general medical settings since 2004. Yet less than one in six US adults report health care professionals discussing alcohol with them. Little is known about methods for increasing implementation; different staffing models may be related to implementation effectiveness. This implementation trial compared delivery of alcohol screening, brief intervention and referral to specialty treatment (SBIRT) by physicians versus non-physician providers receiving training, technical assistance, and feedback reports...
November 19, 2015: Addiction Science & Clinical Practice
Jillian Mullen, Stacy R Ryan, Charles W Mathias, Donald M Dougherty
BACKGROUND: Alcohol use patterns that are hazardous for one's health is prevalent among DWI (driving while intoxicated) offenders and is a key predictor of recidivism. The aim of this program evaluation was to determine the feasibility and usability of implementing a computer-assisted screening, brief intervention and referral to treatment (SBIRT) program for DWI offenders to enable the identification of those in need of treatment services soon after arrest. Our treatment program consisted of a web-based, self-guided screening tool for assessing alcohol use patterns and generating a personalized feedback report that is then used to deliver a brief motivational intervention and if needed, a referral to treatment...
November 9, 2015: Addiction Science & Clinical Practice
Edwin D Boudreaux, Beau Abar, Brianna Haskins, Brigitte Bauman, Grant Grissom
BACKGROUND: Computer technologies hold promise for implementing tobacco screening, brief intervention, and referral to treatment (SBIRT). This study aims to evaluate a computerized tobacco SBIRT system called the Health Evaluation and Referral Assistant (HERA). METHODS: Smokers (n = 421) presenting to an emergency department were randomly assigned to the HERA or a minimal-treatment Control and were followed for 3 months. Analyses compared smoking cessation treatment provider contact, treatment initiation, treatment completion, and smoking behavior across condition using univariable comparisons, generalized estimating equations (GEE), and post hoc Chi square analyses...
November 5, 2015: Addiction Science & Clinical Practice
Alex H S Harris, Shalini Gupta, Thomas Bowe, Laura S Ellerbe, Tyler E Phelps, Anna D Rubinsky, John W Finney, Steven M Asch, Keith Humphreys, Jodie Trafton
BACKGROUND: In order to monitor and ultimately improve the quality of addiction treatment, professional societies, health care systems, and addiction treatment programs must establish clinical practice standards and then operationalize these standards into reliable, valid, and feasible quality measures. Before being implemented, quality measures should undergo tests of validity, including predictive validity. Predictive validity refers to the association between process-of-care quality measures and subsequent patient outcomes...
October 31, 2015: Addiction Science & Clinical Practice
Monica Bawor, Brittany B Dennis, Charlie Tan, Guillaume Pare, Michael Varenbut, Jeff Daiter, Carolyn Plater, Andrew Worster, David C Marsh, Meir Steiner, Rebecca Anglin, Dipika Desai, Lehana Thabane, Zainab Samaan
BACKGROUND: The heritability of opioid use disorder has been widely investigated; however, the influence of specific genes on methadone treatment outcomes is not well understood. The association between response to methadone treatment and genes that are involved in substance use behaviors and reward mechanisms is poorly understood, despite evidence suggesting their contribution to opioid use disorder. The aim of this study was to investigate the effect of brain-derived neurotrophic factor (BDNF) and dopamine receptor D2 (DRD2) polymorphisms on continued opioid use among patients on methadone treatment for opioid use disorder...
October 6, 2015: Addiction Science & Clinical Practice
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