A range of innovative computer-based interventions for psychiatric disorders have been developed, and are promising for drug use disorders, due to reduced cost and greater availability compared to traditional treatment. Electronic searches were conducted from 1966 to November 19, 2009 using MEDLINE, Psychlit, and EMBASE. 468 non-duplicate records were identified. Two reviewers classified abstracts for study inclusion, resulting in 12 studies of moderate quality. Eleven studies were pilot or full-scale trials compared to a control condition. Interventions showed high acceptability despite substantial variation in type and amount of treatment. Compared to treatment-as-usual, computer-based interventions led to less substance use as well as higher motivation to change, better retention, and greater knowledge of presented information. Computerbased interventions for drug use disorders have the potential to dramatically expand and alter the landscape of treatment. Evaluation of internet and phone-based delivery that allow for treatmenton-demand in patients' own environment is needed.Automated computer-based treatment is a promising vehicle for providing behaviorallybased interventions for drug use disorders. These systems offer a number of potential advantages, including low cost, greater accessibility and 24-hour availability, opportunity for more frequent and/or longer therapeutic contact, greater confidentiality, increased flexibility and convenience, and increased opportunities for practicing skills (Budman, 2000;Marks, Shaw, & Parkin, 1998;Nadelson, 1987). Such systems may even be preferred by some clients who dislike therapy or have concerns about confidentiality, and may be particularly useful in rural or remote settings, where access to psychotherapy for substance use disorders may be limited and accompanied by increased stigma (Connors, Tonnigan, & Miller, 2001;Hall & Huber, 2000). Automated computer-based systems also offer more consistent and precise delivery of interventions across patients. This standardization can be of value therapeutically and, from a scientific perspective, may permit a detailed examination of active components. The current systematic review evaluated computer-based interventions for drug use disorders. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. , 2008). This may be due to differences in length of respective computer-based interventions since interventions in tobacco studies (e.g., 10-12 weeks) tend to be longer than those in alcohol studies (e.g., short assessment with personalized feedback). Moreover, within computer-based smok...

Objective-Differences in psychiatric distress and substance use (licit and illicit) were examined in methadone maintenance treatment (MMT) patients with a variety of pain experiences.Method-Parametric and non-parametric statistical tests were performed on data obtained from 150 patients currently enrolled in MMT.Results-In comparison to MMT patients reporting no pain in the previous week, those with chronic severe pain (CSP) (i.e., pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) exhibited significantly higher (p < 0.01) levels of depression, anxiety, somatization, overall psychiatric distress, and personality disorder criteria, but reported comparable rates of substance use. A third group, i.e., non-CSP MMT patients reporting some pain in the past week, differed significantly (p < 0.05) from the other two pain groups on somatization, anxiety, and global psychiatric distress but reported comparable rates of substance use.Conclusions-Pain-related differences in psychiatric problems exist in MMT patients and may have implications for program planning and outreach efforts.

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We surveyed 150 methadone maintenance treatment program (MMTP) patients about pain, pain treatment utilization, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment at the MMTP. Respondents with chronic severe pain (CSP) (i.e., pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) and “some pain” (i.e., pain reported in the previous week but not CSP) endorsed similar rates of past-week and lifetime allopathic or standard medical (with the exception of lifetime medical use of non-opiate medication) and complementary and alternative medicine (CAM) utilization for pain reduction. Prior pain treatments were perceived to be less effective by CSP than SP patients but both groups had equivalent high rates of interest in pain treatment associated with the MMTP. These findings may have implications for resource and program planning in MMT programs.

Objective The aim of this study was to examine the association of pain catastrophizing and pain coping strategies with characteristic pain intensity (an average of worst, least, and typical pain intensity in the past week) and recent pain-related disability (an average of three measures of past week pain interference) in opioid dependent patients enrolled in a methadone maintenance treatment program (MMTP) who reported recent pain. Design Cross-sectional survey. Patients One hundred and eight MMTP patients who reported recent pain. Measures Participants completed measures of demographics, pain status (i.e. “chronic severe pain” [pain lasting at least 6 months with at least moderate pain intensity or significant pain interference in the past week] vs. “some pain” [pain in the past week not meeting the threshold of chronic severe pain]), characteristic pain intensity, recent pain-related disability, somatization, depression, catastrophizing, and pain coping strategies. Results Catastrophizing explained a significant proportion of the variance in characteristic pain intensity (14%) and recent pain-related disability (11%) after controlling for demographics, pain status, somatization, and depression. Mirroring the findings of studies of non-opioid dependent chronic pain patients, greater catastrophizing was associated with greater pain intensity and increases in recent pain-related disability. On average, the chronic severe pain group reported higher levels of catastrophizing than the some pain group. Conclusion Consistent with studies of patients with chronic pain who are not opioid dependent, our findings emphasize the importance of assessing and addressing catastrophizing in MMTP patients with pain.