Adolescent Substance Use Disorder Treatment: an Update on Evidence-Based Strategies

Fadus, Matthew C.; Squeglia, Lindsay M.; Valadez, Emilio A.; Tomko, Rachel L.; Bryant, Brittany E.; Gray, Kevin M.

doi:10.1007/s11920-019-1086-0

Cited by 65 publications

(37 citation statements)

References 97 publications

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“…A small number of studies support the effectiveness of residential treatment for SUD in adult populations [8], but less is known about residential programs that cater to young people with SUD [9]. Psychosocial interventions such as family-based therapies, cognitive behavioural therapy, motivational interviewing/motivational enhancement therapy, and third-wave cognitive behavioural therapies are effective for the treatment of young people with SUD [10]. These broad psychosocial interventions may be particularly beneficial when integrated in residential treatment for young people with SUD because a range of co-occuring mental disorders are very common in this population and difficult to treat, though integrated care represents the most effective form of treatment [11,12].…”

Section: Introductionmentioning

confidence: 99%

Now and then: a ten-year comparison of young people in residential substance use disorder treatment receiving group dialectical behaviour therapy

et al. 2021

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Background Reducing substance use in youth is a global health priority. We compared two cohorts from the same 12-week residential substance use disorder (SUD) facility over a 10 year period: Cohort A (2008–2009) and Cohort B (2018–2020). The essential components of the program remained the same with the primary treatment being dialectical behaviour therapy (DBT) plus residential milieu. Methods Young people in the current Cohort B (N = 100) versus historical Cohort A (N = 102) had a similar ratio of males (74 vs. 70%) but were slightly older (mean 20.6 vs. 19.5 years). Linear mixed models were used to model outcome measures (global psychiatric symptoms, substance use severity, and quality of life) longitudinally up to 12 months later. Results Baseline to end-of-treatment comparisons showed that the current Cohort B had overall higher levels of global psychiatric symptoms (d = 0.70), but both groups reduced psychiatric symptoms (Cohort A: d = 1.05; Cohort B: d = 0.61), and had comparable increases in confidence to resist substance use (d = 0.95). Longitudinal data from the current Cohort B showed significant decreases in substance use severity from baseline to 6-month follow-up (d = 1.83), which were sustained at 12-month follow-up (d = 0.94), and increases in quality of life from baseline to end-of-treatment (d = 0.83). Conclusions We demonstrate how DBT plus milieu residential care for young people continues to show positive effects in a 10-year comparison. However, youth seeking treatment today compared to 10 years ago evidenced higher acuity of psychiatric symptoms reinforcing the importance of continuous improvement of psychological treatments. Trial registration Australian New Zealand Clinical Trials Registry: trial IDACTRN12618000866202, retrospectively registered on 22/05/2018, .

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Section: Introductionmentioning

confidence: 99%

Now and then: a ten-year comparison of young people in residential substance use disorder treatment receiving group dialectical behaviour therapy

et al. 2021

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“…The rationale for the testing animals at this developmental stage is because disorders associated with increased DAD 2 sensitivity are neurodevelopmental and persist throughout the lifespan (Gill et al, 2020). Furthermore, this is the developmental period in which cigarette smoking and substance abuse often initiates (Fadus et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

Transgenerational evidence of increases in dopamine D2 receptor sensitivity in rodents: Impact on sensorimotor gating, the behavioral response to nicotine and BDNF

et al. 2021

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Background/Aims: Neonatal quinpirole (NQ) treatment to rats increases dopamine D2 (DAD2) receptor sensitivity in adult animals. We investigated if increased DAD2 sensitivity would be passed to the next (F1) generation, and if these animals demonstrated sensorimotor gating deficits and enhanced behavioral responses to nicotine. Methods: Male and female rats were intraperitoneal (IP) administered quinpirole (1 mg/kg) or saline (NS) from postnatal day (P)1–21. Animals were either behaviorally tested (F0) or raised to P60 and mated, creating F1 offspring. Results: Experiment 1 revealed that F1 generation animals that were the offspring of at least one NQ-treated founder increased yawning behavior, a DAD2-mediated behavioral event, in response to acute quinpirole (0.1 mg/kg). F1 generation rats also demonstrated increased striatal β arrestin-2 and decreased phospho-AKT signaling, consistent with increased G-protein independent DAD2 signaling, which was equal to F0 NQ-treated founders, although this was not observed in all groups. RNA-Seq analysis revealed significant gene expression changes in the F1 generation that were offspring of both NQ-treated founders compared to F0 NQ founders and controls, with enrichment in sensitivity to stress hormones and cell signaling pathways. In Experiment 2, all F1 generation offspring demonstrated sensorimotor gating deficits compared to controls, which were equivalent to F0 NQ-treated founders. In Experiment 3, all F1 generation animals demonstrated enhanced nicotine behavioral sensitization and nucleus accumbens (NAcc) brain-derived neurotrophic factor (BDNF) protein. Further, F1 generation rats demonstrated enhanced adolescent nicotine conditioned place preference equivalent to NQ-treated founders conditioned with nicotine. Conclusions: This represents the first demonstration of transgenerational effects of increased DAD2 sensitivity in a rodent model.

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“…Digital behavioral interventions, which rely on digital technologies to promote behavior change and maintain health [ 1 ], have been growing rapidly over the past several decades. Digital approaches have unique potential benefits in promoting behavioral health, especially with regard to risky behaviors and sensitive or stigmatized topics (eg, drug and alcohol use [ 2 - 4 ], sexual health [ 5 , 6 ], and mood and anxiety [ 7 ]) that many are hesitant to discuss openly [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Perceived Benefits of Digital Interventions for Behavioral Health: Qualitative Interview Study

Marcu¹,

Ondersma²,

Spiller³

et al. 2022

J Med Internet Res

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Background Digital interventions have gained momentum in terms of behavioral health. However, owing to lacking standard approaches or tools for creating digital behavioral interventions, clinical researchers follow widely varying conceptions of how best to go about digital intervention development. Researchers also face significant cost-, time-, and expertise-related challenges in digital intervention development. Improving the availability of tools and guidance for researchers will require a thorough understanding of the motivations and needs of researchers seeking to create digital interventions. Objective This study aims to understand the perceptions of behavioral researchers toward digital interventions, and inform the use of these interventions, by documenting the reasons why researchers are increasingly focusing their efforts on digital interventions and their perspectives on the perceived benefits that digital approaches can provide for researchers and intervention recipients. Methods We conducted semistructured qualitative interviews with 18 researchers who had experience designing digital behavioral interventions or running studies with them. A convenience sample of interviewees was recruited from among users of the Computerized Intervention Authoring System platform, a web-based tool that facilitates the process of creating and deploying digital interventions in behavioral research. Interviews were conducted over teleconference between February and April 2020. Recordings from the interviews were transcribed and thematically analyzed by multiple coders. Results Interviews were completed with 18 individuals and lasted between 24 and 65 (mean 46.9, SD 11.3) minutes. Interviewees were predominantly female (17/18, 94%) and represented different job roles, ranging from researcher to project or study staff. Four major themes came out of the interviews concerning the benefits of digital interventions for behavioral health: convenience and flexibility for interventionists and recipients, support for implementing evidence-based interventions with fidelity, scaling and improving access to interventions, and getting a foot in the door despite stigma and disenfranchisement. Conclusions Interviewees described a number of important potential benefits of digital interventions, particularly with respect to scientific rigor, scalability, and overcoming barriers to reaching more people. There are complex considerations with regard to translating behavior change strategies into digital forms of delivery, and interventionists make individual, sometimes unexpected, choices with minimal evidence of their relative effectiveness. Future research should investigate how behavioral researchers can be supported in making these choices toward usability, ease of access, and approachability of digital interventions. Our study underscores the need for authoring platforms that can facilitate the process of creating and deploying digital interventions to reach their full potential for interventionists and recipients alike.

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Adolescent Substance Use Disorder Treatment: an Update on Evidence-Based Strategies

Cited by 65 publications

References 97 publications

Now and then: a ten-year comparison of young people in residential substance use disorder treatment receiving group dialectical behaviour therapy

Now and then: a ten-year comparison of young people in residential substance use disorder treatment receiving group dialectical behaviour therapy

Transgenerational evidence of increases in dopamine D2 receptor sensitivity in rodents: Impact on sensorimotor gating, the behavioral response to nicotine and BDNF

The Perceived Benefits of Digital Interventions for Behavioral Health: Qualitative Interview Study

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