Journal of substance abuse treatment
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J Subst Abuse Treat · Aug 2014
Randomized Controlled Trial Multicenter StudyReasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain.
The number of individuals seeking treatment for prescription opioid dependence has increased dramatically, fostering a need for research on this population. The aim of this study was to examine reasons for prescription opioid use among 653 participants with and without chronic pain, enrolled in the Prescription Opioid Addiction Treatment Study, a randomized controlled trial of treatment for prescription opioid dependence. ⋯ Participants with chronic pain rated using opioids to cope with physical pain as more important, and using opioids in response to social interactions and craving as less important, than those without chronic pain. Results highlight the importance of physical pain as a reason for opioid use among patients with chronic pain.
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J Subst Abuse Treat · Jul 2013
Randomized Controlled Trial Multicenter StudyGender differences in a clinical trial for prescription opioid dependence.
Although gender differences in substance use disorders have been identified, few studies have examined gender differences in prescription drug dependence. The aim of this study was to examine gender differences in clinical characteristics and treatment outcomes in a large clinical trial for prescription opioid dependence. Despite no pre-treatment differences in opioid dependence severity, women reported significantly greater functional impairment, greater psychiatric severity, and higher likelihood of using opioids to cope with negative affect and pain than men. ⋯ Men reported significantly more alcohol problems than women. There were no significant gender differences in medication dose, treatment retention, or opioid outcomes. Thus, despite the presence of pre-treatment gender differences in this population, once the study treatment was initiated, women and men exhibited similar opioid use outcomes.
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J Subst Abuse Treat · May 2013
Randomized Controlled Trial Multicenter StudyImpulsivity is associated with treatment non-completion in cocaine- and methamphetamine-dependent patients but differs in nature as a function of stimulant-dependence diagnosis.
Greater impulsivity, assessed by the Barratt Impulsiveness Scale-11 (BIS-11) and Stroop interference scores, has been associated with treatment completion in cocaine-dependent patients. This study evaluated the relationships among impulsivity, stimulant-dependence diagnosis, and treatment completion. Six sites evaluating 12-step facilitation for stimulant abusers obtained the BIS-11 and Stroop from 182 methamphetamine- and/or cocaine-dependent participants. ⋯ There was a trend for poorer response inhibition, measured by the Stroop, in cocaine-dependent, relative to methamphetamine-dependent, participants. Accounting for other factors related to treatment completion, BIS-11 motor score, assessing the tendency to act without thinking, predicted treatment completion for both cocaine-dependent and methamphetamine-dependent patients. These results suggest that methamphetamine-dependent and cocaine-dependent patients may have different impulsivity profiles but that the BIS-11 may be useful in identifying both methamphetamine-dependent and cocaine-dependent patients who are at risk for treatment non-completion.
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J Subst Abuse Treat · Jan 2013
Randomized Controlled TrialEfficacy of an emergency department-based multicomponent intervention for smokers with substance use disorders.
The efficacy of brief emergency department (ED)-based interventions for smokers with concurrent alcohol or substance use is unknown. We performed a subgroup analysis of a trial enrolling adult smokers in an urban ED, focusing on subjects who screened positive for alcohol abuse or illicit drug use. Subjects receiving usual care (UC) were given a smoking cessation brochure; those receiving enhanced care (EC) got the brochure, a brief negotiated interview, 6 weeks of nicotine patches, and a telephone call. ⋯ Of 340 subjects in the parent study, 88 (25.9%) reported a substance use disorder. At 3 months, substance users receiving EC were more likely to be tobacco-abstinent than those receiving UC (14.6% versus 0%, p = .015), and to self-identify as nonsmokers (12.5% v. 0%, p = .03). This finding suggests that concurrent alcohol or substance use should not prevent initiation of tobacco dependence treatment in the ED.
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J Subst Abuse Treat · Jan 2013
Randomized Controlled Trial Comparative StudyCategorical 12-step involvement and continuous abstinence at 2 years.
A longitudinal analysis of 12-step involvement was conducted among a U. S. sample of patients exiting treatment for substance dependence. ⋯ In addition, participants in the Oxford House condition were significantly more likely to remain continuously abstinent throughout the course of this randomized clinical trial. Findings suggest that categorical involvement in a set of 12-step activities and communal-living settings such as Oxford Houses are independent factors associated with continuous abstinence from both alcohol and illicit drugs among substance dependent persons.