- Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: A qualitative study. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:7-14
- CONCLUSIONS: AFMs who access informal and formal help sources for themselves, and on behalf of their relative, are more likely to sustain their important support-giving role. Measures to strengthen AFMs' capacity and willingness to support their relative should be founded on an understanding of factors that affect their own help-seeking in addition to those encountered when help-seeking on behalf of their relative. Our findings have implications for the visibility of AOD services and informal support groups on the Internet, organisational culture of some AOD services, valuing the contributions of AFMs, and protecting AFMs and their relatives' privacy. Our findings also have implications for reducing public stigma of AOD misuse, changing some AFMs' scepticism about treatment outcomes, and reinforcing and enhancing AFMs' skills in persevering with help-seeking.
- Differential relationships of PTSD and childhood trauma with the course of substance use disorders. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:57-63
- A large body of research documents the link between Posttraumatic Stress Disorder (PTSD) and the course of Substance Use Disorders (SUD). Similar relationships have been reported between Childhood Tr...
A large body of research documents the link between Posttraumatic Stress Disorder (PTSD) and the course of Substance Use Disorders (SUD). Similar relationships have been reported between Childhood Trauma (CT) and the course of illness in patients with SUD even in the absence of PTSD, but few studies have examined differential effects of PTSD and CT (independent of PTSD) in this population. We used the International Diagnostic Checklist (IDCL) and the Posttraumatic Diagnostic Scale (PDS) to diagnose PTSD in a sample of patients with SUD (N = 459). The Childhood Trauma Questionnaire (CTQ) and the European Addiction Severity Index (EuropASI) were administered to assess childhood trauma and addiction related problems including comorbid psychopathological symptoms. The sample was divided into three groups: patients with experiences of CT and PTSD (CT-PTSD), experiences of CT without PTSD (CT-only), and neither experiences of CT nor PTSD (No trauma) to examine their differential associations with the course and severity of SUD. Patients of both the CT-PTSD (n = 95) and the CT-only group (n = 134) reported significantly higher levels of anxiety and depression as well as more suicidal thoughts and suicide attempts during their lifetime than the No trauma group (n = 209). Regarding most variables a graded association became apparent, with the highest level of symptoms in the CT-PTSD group, an intermediate level in the CT-only group and the lowest level in the No trauma group. The CT-PTSD group also differed in almost all substance use variables significantly from the No trauma group, including a younger age at first use of alcohol and cannabis, more cannabis use in the last month, and more lifetime drug overdoses. Our results confirm the relationships of both CT and PTSD with psychiatric symptoms in patients with SUD. Thus, it seems important to include both domains into the routine assessment of SUD patients. Specific treatments for comorbid PTSD but also for other consequences of childhood trauma should be integrated into SUD treatment programs.
- Evaluating moderators of beneficial effects of severity-based assignment to substance use treatments in impaired drivers. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:49-56
- Remedial programs for impaired driving offenders have proved valuable in reducing subsequent alcohol and other drug use and preventing recidivism in this population. Many of these programs are based ...
Remedial programs for impaired driving offenders have proved valuable in reducing subsequent alcohol and other drug use and preventing recidivism in this population. Many of these programs are based on a severity-based assignment scheme, where individuals assessed to have greater problems or be at higher risk are assigned to longer, more intensive interventions. Recent research, using regression discontinuity analyses, provided support for severity-based assignment schemes in demonstrating that those with higher problem or risk levels assigned to longer and more intensive programming showed a significant reduction in drinking days over a follow-up interval, attributable to program assignment. Regression discontinuity analyses can also be used to assess moderators of this assignment benefit. We report an assessment of the impact of eight potential moderators of assignment benefit, derived from a factor analysis of the Research on Addictions Self-Inventory screening instrument. Five of the eight factors were found to moderate the assignment benefit: Negative Affect, Sensation Seeking, High Risk Lifestyle, Alcohol Problems, and Family History. The significance of these results for developing more effective program assignment procedures is discussed.
- Persistence/recurrence of and remission from DSM-5 substance use disorders in the United States: Substance-specific and substance-aggregated correlates. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:38-48
- This study examined demographic and psychosocial correlates associated with persistence/recurrence of and remission from at least one of ten DSM-5 substance use disorders (SUDs) and three substance-s...
This study examined demographic and psychosocial correlates associated with persistence/recurrence of and remission from at least one of ten DSM-5 substance use disorders (SUDs) and three substance-specific SUDs (i.e., alcohol, cannabis, and prescription opioids). Data were collected from structured diagnostic interviews and national prevalence estimates were derived from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. An estimated 25.4% of the U.S. population had at least one prior-to-past-year (prior) SUD. Among individuals with any prior SUDs, the prevalence of past-year substance use and DSM-5 symptomology was as follows: abstinence (14.2%), asymptomatic use (36.9%), symptomatic use (10.9%), and persistent/recurrent SUD (38.1%). Among individuals with prior SUDs, design-based multinomial logistic regression analysis revealed that young adulthood, higher educational attainment, higher personal income, never having been married, being divorced/separated/widowed, lack of lifetime substance use treatment, and stressful life events predicted significantly greater odds of past-year persistent/recurrent SUDs, relative to abstinence. In addition, remission from a prior tobacco use disorder decreased the probability of past-year persistent/recurrent SUD, relative to abstinence. Stressful life events were the only common correlates across the aggregation of all SUDs and each substance-specific SUD, but differences were found for specific stressful life events between drug classes. Nearly half (49%) of adults with prior DSM-5 SUDs continued to report past-year symptomatic substance use, while only one in seven individuals were abstinent. The findings suggest the value of examining remission associated with both substance-specific SUDs and aggregation of SUDs based on the shared and unique correlates of persistent/recurrent SUDs; this is especially true for stressful life events, which could be useful targets for enhancing clinical care and interventions.
- U.S. adults with opioid use disorder living with children: Treatment use and barriers to care. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:31-37
- CONCLUSIONS: Most adults with opioid use disorder who live with a child are not receiving any substance use treatment. Efforts to expand opioid use disorder treatment programs must include investment in programs that meet the specialized needs of families.
- Increased distance was associated with lower daily attendance to an opioid treatment program in Spokane County Washington. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:26-30
- CONCLUSIONS: This study found significant positive associations between distance to an OTP and the number of missed doses in the first month of treatment. Findings suggest the need to improve the spatial availability of OTPs to optimize opioid use disorder treatment outcomes.
- Comparison between buprenorphine provider availability and opioid deaths among US counties. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:19-25
- CONCLUSIONS: Substantial county-level imbalances between the availability of buprenorphine providers and the burden of opioid overdose deaths are present within the US.
- Young adults' perceptions of acceptability and effectiveness of a text message-delivered treatment for cannabis use disorder. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:15-18
- CONCLUSIONS: These findings provide insight into the acceptability of the text-delivered treatment platform and potential mechanisms of behavior change for PNC-txt. The participants provided positive feedback about the treatment and indicated that it helped reduce their cannabis use. Given the acceptability and promising efficacy of PNC-txt, continued research is warranted, particularly with adolescents and with larger samples.
- Mobilizing community support in people receiving opioid-agonist treatment: A group approach. [Journal Article]
- JSJ Subst Abuse Treat 2018; 93:1-6
- This descriptive study evaluates a novel group intervention designed to help opioid-dependent patients in medication-assisted treatment identify and recruit drug-free individuals to support recovery ...
This descriptive study evaluates a novel group intervention designed to help opioid-dependent patients in medication-assisted treatment identify and recruit drug-free individuals to support recovery efforts. The Social Network Activation Group works with patients who are actively using drugs and resistant to including drug-free family or friends in treatment. The group encourages patients to attend structured recovery, religious, or recreational activities in the community to find recovery support. For those with underutilized support, motivational interviewing and skills training are used to help patients resolve ambivalence and include family or friends in the treatment plan. Patients earn up to one methadone take-home each week that they attend the group and verify activity participation. They complete the group after introducing a drug-free family member or friend to their counselor. This study reports on a sample of 66 patients referred to this group as part of intensive outpatient treatment. Patients attended 71% of scheduled sessions and participated in a M = 4.3 activities. Mutual-help support groups (64%) and church (28%) were the activities most often attended. Thirty-six percent brought in a drug-free family or friend to meet their counselor. Family members were the most common choice (67%). The results demonstrate preliminary feasibility and mixed efficacy of the Social Network Activation Group for this highly select sample of patients, and provide additional evidence that many patients possess drug-free family or friends who are willing to support recovery efforts.
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- Corrigendum to "Developing an opioid use disorder treatment cascade: A review of quality measures" [Journal of Substance Abuse Treatment 91 (2018) 57-68]. [Published Erratum]
- JSJ Subst Abuse Treat 2018; 92:99