BackgroundHigh rates of substance misuse during emerging adulthood require developmentally appropriate clinical programs.ObjectivesThis work outlines the development of an evidence-informed emerging adult outpatient substance use program, quality improvement process and protocol, and 1-year program insights.MethodsLiterature reviews, program reviews, environmental scans, and stakeholder consultations (including lived expertise) were used to develop the program. A 12-week emerging adult (17-25) measurement-based care program was developed including: 1) individual measurement-based care and motivational enhancement therapy sessions; 2) group programming focused on cognitive behavioural therapy, mindfulness, distress tolerance, and emotional regulation; 3) consults for diagnostic clarification and/or medication review; and 4) a separate education group for loved ones. A measurement system was concurrently created to collect clinical and program evaluation data at 6 time points.ResultsIn the first year of the program, 96 young adults fully enrolled in the program (Mean age = 21 years old, 48% female gender) primarily reporting treatment targets of alcohol (70%) and cannabis (59%). Almost all patients (97%) surpassed at least one clinical threshold for co-occurring mental health disorder, with the median/mode of positive psychiatric screens being for 5 conditions.ConclusionsThis program demonstrates that developing an integrative evidence-informed measurement-based care young adult substance use program is feasible, though requires flexibility and ongoing monitoring to meet local needs. Patient characteristics reveal very high rates of concurrent psychiatric disorders in addition to substance use disorders.

Addiction continues to be a major public health concern, and rates of relapse following currently-available treatments remain high. There is increasing interest in the adjunctive use of mindfulness-based interventions, such as yoga, to improve treatment outcomes. The current study was a preliminary naturalistic investigation of a novel trauma-informed yoga intervention in an inpatient treatment program for women with substance use disorder (SUD). Changes and differences in somatic symptoms, psychiatric symptoms, and psychological mechanisms were evaluated in women receiving treatment-as-usual (n = 36) and treatment-as-usual plus the yoga intervention (n = 42). For both groups, statistically significant within-subjects changes were present for somatic and psychiatric symptoms, cravings, self-efficacy, and multiple facets of impulsivity and mindfulness. Compared to standard treatment alone, participants in the treatment plus yoga condition significantly improved in range of motion and the Lack of Premeditation facet of impulsivity. Although most domains were not selectively affected, these initial within-treatment findings in this naturalistic evaluation suggest some promise for adjunctive yoga and a need for further evaluation, especially using larger samples and longer term follow-up.

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ObjectiveInpatient treatment programs for substance use disorders (SUDs) typically have an abstinence policy for patients, but unsanctioned substance use nonetheless takes place and can have significant negative clinical impacts. The current study sought to understand this problem from a patient perspective and to develop strategies for improved contraband substance management in an inpatient concurrent disorders sample.MethodsFirst, a qualitative study (n = 10; 60% female) was undertaken to ascertain perceived prevalence, impact, and patient-generated strategies. Second, an anonymous follow-up survey was conducted with unit staff clinicians to evaluate the suggested strategies.ResultsPatients reported that contraband substance use was present and had significant negative consequences clinically. Recommendations from patients included more extensive urine drug screening, the use of drug-sniffing dogs, and direct contingencies for contraband use. Nineteen staff competed an anonymous follow-up questionnaire to evaluate the viability of these strategies, revealing variable perceptions of feasibility and effectiveness.ConclusionThese findings emphasize the adverse consequences of contraband substance use in addiction treatment programs and identify patient-preferred strategies for managing this challenge.