A randomized trial of computerized vs. in-person brief intervention for illicit drug use in primary care: Outcomes through 12months

Gryczynski, Jan; Mitchell, Shannon Gwin; Gonzales, Arturo; Moseley, Ana; Peterson, Tom; Ondersma, Steven J.; O’Grady, Kevin E.; Schwartz, Robert P.

doi:10.1016/j.jsat.2014.09.002

Cited by 34 publications

(22 citation statements)

References 36 publications

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“…Platforms for delivering addiction interventions via technology are diverse and multiplying rapidly. These include electronic screening and brief intervention (eSBIs)(Carey, Scott-Sheldon, Elliott, Bolles, & Carey, 2009; Copeland & Martin, 2004; Fachini, Aliane, Martinez, & Furtado, 2012; Gryczynski et al, 2015; Ondersma, Svikis, & Schuster, 2007); web-based multi-module programs and smartphone apps, with and without clinician involvement (Bickel, Marsch, Buchhalter, & Badger, 2008; Gustafson et al, 2014; Suffoletto et al, 2015) treatment delivered ‘live’ via Skype, telephone, or instant messaging (McKay, Lynch, Shepard, & Pettinati, 2005; McKay et al, 2004; McKay et al, 2011; McKay et al, 2010); monitoring via interactive voice response (IVR) and Ecological Momentary Assessment (EMA) and Ecological Momentary Treatment (EMT) platforms (Moore et al, 2013; Morgenstern, Kuerbis, & Muench, 2014) and several more (Muench, 2014). Overall, results from meta-analyses of such interventions are promising (Boumparis, Karyotaki, Schaub, Cuijpers, & Riper, in press; Carey et al, 2009; Riper et al, 2014; Rooke, Thorsteinsson, Karpin, Copeland, & Allsop, 2010; Tait, Spijkerman, & Riper, 2013), but methodological quality of studies within this young field is variable and often weak (Kiluk, Sugarman, et al, 2011).…”

Section: The Promise Of Technologymentioning

confidence: 99%

Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again.

Carroll¹,

Kiluk²

2017

Psychology of Addictive Behaviors

163

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Cognitive behavioral therapy (CBT) approaches have among the highest level of empirical support for the treatment of drug and alcohol use disorders. As Psychology of Addictive Behaviors marks its 30th anniversary, we review the evolution of CBT for the addictions through the lens of the Stage Model of Behavioral Therapies Development. The large evidence base from Stage II randomized clinical trials indicates a modest effect size with evidence of relatively durable effects, but limited diffusion in clinical practice, as is the case for most empirically validated approaches for mental health and addictive disorders. Technology may provide a means for CBT interventions to circumvent the ‘implementation cliff’ in Stages 3–5 by offering a flexible, low-cost, standardized means of disseminating CBT in a range of novel settings and populations. Moreover, returning to Stage 1 to reconnect clinical applications of CBT to recent developments in cognitive science and neuroscience holds great promise for accelerating understanding of mechanisms of action. It is critical that CBT not be considered as a static intervention, but rather one that constantly evolves and is refined through the Stage model until the field achieves a maximally powerful intervention that addresses core features of the addictions.

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Section: The Promise Of Technologymentioning

confidence: 99%

Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again.

Carroll¹,

Kiluk²

2017

Psychology of Addictive Behaviors

163

View full text Add to dashboard Cite

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“…The methodology and results of the trial have been described in detail elsewhere (Gryczynski et al, in press; Schwartz et al, 2014). Briefly, 360 adult patients with moderate-risk illicit drug misuse as defined by the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) (Humeniuk et al, 2008) were randomly assigned on a 1:1 basis to receive an interactive computerized brief intervention (CBI) or an in-person brief intervention (IBI) delivered by an experienced, Masters-level behavioral health counselor.…”

Section: Methodsmentioning

confidence: 99%

“…The study found no significant differences between IBI and CBI on the primary outcomes of global ASSIST drug risk scores or drug-positive hair test results, while CBI outperformed IBI on several substance-specific drug risk scores examined as secondary outcomes. Analyses to date have examined the results of hair drug testing and self-reported ASSIST scores at a 3-month endpoint (Schwartz et al, 2014), and in terms of differential change through 12-months of follow-up (Gryczynski et al, in press). In summary, these analyses found no overall reductions, or between-condition differences in drug hair test results.…”

Section: Methodsmentioning

confidence: 99%

Potential Radiating Effects of Misusing Substances Among Medical Patients Receiving Brief Intervention

Gryczynski

Mitchell

Ondersma

et al. 2015

Journal of Substance Abuse Treatment

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Background The societal benefits of substance use interventions are largely driven not by reducing use per se, but by the broader implications of those reductions. This encompasses “potential radiating effects of misusing substances” (PREMiS) such as utilization of high-cost hospital and emergency care, injury, productivity losses, incarceration, and driving while impaired. Methods This study is a secondary analysis from a randomized trial comparing in-person vs. computerized brief intervention among 360 adult community health center patients with moderate-risk illicit drug use (N= 302 with complete data through 12 months of follow-up). This study aims to examine four aspects of PREMiS outcomes in this sample: (1) their frequency; and their association with (2) type of brief intervention received (by random assignment), (3) type of drug misused, and (4) baseline drug problem severity (within the moderate risk range). Results 12-month prevalence was 18.5% for hospitalization (399 cumulative days), 33.1% for emergency department utilization (166 cumulative visits), 39.1% for injury (1818 injury-days), and 8.3% for incarceration (278 days of detention). There were 729 missed work days among those who reported employment. Fifty percent reported driving under the influence (DUI) of substances. There were no differences in PREMiS outcomes by type of brief intervention. Participants with only marijuana misuse at baseline were not at lower risk of experiencing PREMiS events than participants with other drug misuse. Higher baseline drug problem severity was predictive of future hospitalization (p<.05) and number of hospitalization days (p<.01). Conclusion This community health center sample with moderate-risk illicit drug use reported considerable high-cost healthcare utilization, injury, missed work, and DUI. Interventions are needed that can reliably lower risk of negative outcomes among drug users.

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“…However few studies in the US or Mexico provide reliable estimates of the prevalence of drug use in primary care settings required to implement this strategy (Gelberg et al, 2015; Gryczynski et al, 2014; Lebrun-Harris, Tomoyasu, & Ngo-Metzger, 2014; Lee, Delbanco, Wu, & Gourevitch, 2011; Madras et al, 2009; McNeely et al, 2014a; Roy-Byrne et al, 2014; Saitz et al, 2014; Smith, Schmidt, Allensworth-Davies, & Saitz, 2010). Some information exists regarding the prevalence of substance use along the border for the general household population and emergency room patients, (Borges et al, 2009; Borges et al, 2015; Borges et al, 2011; Cherpitel et al, 2015; Guerrero et al, 2014), SUD specialty treatment centers (Sánchez-Huesca, Arellanez-Hernández, Pérez-Islas, & Rodríguez-Kuri, 2006), or among high risk populations (Chittoor et al, 2013; McDougal et al, 2013; Pitpitan et al, 2013; Servin et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Substance Use Among Patients of Community Health Centers in East Los Angeles and Tijuana

Gelberg

Rey

Andersen³

et al. 2016

Substance Use & Misuse

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Background Given the increased use of psychoactive substances on the US-Mexico border, a binational study (Tijuana, Mexico-Los Angeles, USA) was conducted to identify the prevalence of substance use in primary care settings. Objectives To compare the prevalence and characteristics of patients at risk for substance use disorders in Tijuana and East Los Angeles (LA) community clinics with special attention paid to drug use. Methods Design Observational, cross-sectional, analytical study. Comparison of screening results from patients in Tijuana and LA. Setting 2 community clinics in LA and 6 in Tijuana. Participants 2,507 adult patients in LA and 2,890 in Tijuana eligible for WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening during March-October 2013. Measures WHO ASSIST self-administered on a tablet PC. Results Of eligible patients, 96.4% completed the ASSIST in Tijuana and 88.7% in LA (mean 1.34 minutes and 4.20 minutes, respectively). The prevalence of patients with moderate-to-high substance use was higher in LA than Tijuana for each substance: drugs 19.4% vs. 5.7%, alcohol 15.2% vs. 6.5%, tobacco 20.4% vs. 16.2%. LA patients born in Mexico had 2x the odds and LA patients born in the US had 6x the odds of being a moderate-to-high drug user compared to Tijuana patients born in Mexico. Conclusions Moderate-to-high drug use is higher in LA than in Tijuana but rates are sufficiently high in both to suggest that screening for drug use (along with alcohol and tobacco use) should be integrated into routine primary care of community clinics in both cities.

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A randomized trial of computerized vs. in-person brief intervention for illicit drug use in primary care: Outcomes through 12months

Cited by 34 publications

References 36 publications

Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again.

Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again.

Potential Radiating Effects of Misusing Substances Among Medical Patients Receiving Brief Intervention

Prevalence of Substance Use Among Patients of Community Health Centers in East Los Angeles and Tijuana

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