Patients with opioid addiction who receive prescription opioids for treatment of chronic non-malignant pain present a therapeutic challenge. Fifty-four patients with chronic pain and opioid addiction were randomized to receive methadone or buprenorphine/naloxone. At the 6-month follow-up, 26 (48.1%) participants who remained in the study noted a 12.75% reduction in pain (P = 0.043) and compared to 5 in the buprenorphine group, none in the methadone group reported illicit opioid use (P = 0.039). Other differences between the two conditions were not found. Long-term low-dose methadone or buprenorphine/naloxone treatment produced analgesia in patients with chronic pain and opioid addiction.

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Though relatively understudied, trauma exposure and resulting posttraumatic stress symptoms are common in college students. Web-based surveys allow for private, cost-effective, and time-efficient assessment of trauma and its sequelae in this at-risk population. This study examines two issues pertinent to Internet assessment of trauma and posttraumatic stress: (a) the reliability of the Internet compared with paper-and-pencil and interview assessments and (b) the acceptability of this assessment modality to students. College students (N = 38) completed a posttraumatic stress disorder (PTSD) clinical interview and paper-and-pencil and online versions of trauma and PTSD questionnaires. Results showed in-person and online trauma and PTSD assessments to be significantly associated with each other and with the clinical interview. Participants reported positive reactions to the online survey. Findings suggest that the Internet can reliably and unobtrusively assess potentially sensitive topics in college students.

To determine if the addition of a behavioral intervention during alcohol detoxification would facilitate initiation of subsequent care, we randomized 150 detoxification patients to receive: treatment as usual (TAU), a Motivation Enhancement Therapy (MET) intervention, or a Peer-delivered Twelve Step Facilitation (P-TSF) intervention. The main outcome was the initiation of any type of subsequent care (i.e., professional treatment or self-help) within 30 and 90 days of discharge. Other outcomes included: alcohol and drug use, completion of subsequent professional treatment, and readmission for detoxification. The mean age of the participants was 45 years; 65% were men, and 84% were white. At the 30-day follow-up, there was no significant difference among the groups in the rate of initiation of any type of subsequent care (82%, 74%, and 82% respectively, p = 0.617); however, the MET group had significantly more patients initiate subsequent inpatient treatment by the 90-day follow-up compared to the P-TSF group (31% and 61%, p = 0.007) and a greater proportion of MET participants completed subsequent inpatient treatment compared to both TAU and P-TSF. There were no differences in drinking-related outcomes (e.g., number of days before first drink, percent days abstinent) between the groups. We conclude that MET during detoxification may provide additional benefits in terms of initiating and maintaining patients in aftercare inpatient treatment programs.

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