Aims Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Design Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC) or Delayed Feedback Control (DFC). Those assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to 4 optional individual treatment sessions aimed at cessation of cannabis use. Setting High schools in Seattle, WA, USA. Participants 310 self-referred adolescents who smoked cannabis regularly. Measurements Main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. Findings At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to DFC. Frequency of cannabis use was less in MET relative to EFC at 3 months, but did not translate to differences in negative consequences. Reduction in use and problems were sustained at 12-months but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and not different by condition. Conclusions Brief interventions can attract and have positive impacts on adolescent cannabis users, but the mechanisms of the effects are yet to be identified.

Although continuing care is strongly related to positive treatment outcomes for substance use disorder (SUD), participation rates are low and few effective interventions are available. In a randomized clinical trial with 150 participants (97% men), 75 graduates of a residential Veterans Affairs Medical Center SUD program who received an aftercare contract, attendance prompts, and reinforcers (CPR) were compared to 75 graduates who received standard treatment (STX). Among CPR participants, 55% completed at least 3 months of aftercare, compared to 36% in STX. Similarly, CPR participants remained in treatment longer than those in STX (5.5 vs. 4.4 months). Additionally, CPR participants were more likely to be abstinent compared to STX (57% vs. 37%) after 1 year. The CPR intervention offers a practical means to improve adherence among individuals in SUD treatment.

No abstract

Background As part of the nation's largest dissemination and implementation of evidence-based psychotherapies (EBPs) and the promotion of EBPs for substance use disorders (SUDs), the Veterans Health Administration (VHA) is working to nationally implement Cognitive Behavioral Therapy for SUD (CBT-SUD). The current manuscript describes the approach to system-wide training and reports Veteran outcomes associated with CBT-SUD implementation. Methods Four-hundred fifty-eight Veterans with a range of treatment goals received treatment through the Department of Veterans Affairs (VA) CBT-SUD Training Program. Veteran outcomes related to substance use, substance use-related problems, and quality of life were assessed with the Brief Addiction Monitor, the Short Inventory of Problems, and the World Health Organization Quality of Life-BREF. Results Statistically significant reductions in alcohol use, heavy alcohol use, other drug use, and substance use-related problems, as well as significant improvements in quality of life, were observed over the course of treatment. Conclusions Program evaluation findings suggest that large-scale training in and implementation of EBPs for SUDs is associated with improvements in substance use and other functional outcomes. Limitations from this real-world implementation project, including the lack of a control group and missing post-treatment data, are discussed.