Exclusion criteria in treatment research on alcohol, tobacco and illicit drug use disorders: A review and critical analysis

Moberg, Christine A.; Humphreys, Keith

doi:10.1111/dar.12438

Cited by 32 publications

(21 citation statements)

References 32 publications

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“…Prospective investigational studies conducted in a research context according to study protocols reported much higher adherence rates over time compared to retrospective medical record review studies taken from routine clinical care settings. The reasons for this large divergence are unclear but may include differences between samples owing to study exclusion criteria (71, 72) and a host of procedural differences between investigational studies and routine clinical care (e.g., study compensation, medication cost, follow-up efforts, expertise and familiarity with XR-NTX, contact with healthcare staff) (73). The observed difference in adherence between these two types of studies should be interpreted cautiously, however.…”

Section: Discussionmentioning

confidence: 99%

Extended‐release injectable naltrexone for opioid use disorder: a systematic review

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Extended‐release injectable naltrexone for opioid use disorder: a systematic review

et al. 2018

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“…For example, Humphreys et al (12) found that 20% to 33% of patients with alcohol use disorders would be excluded by the eligibility criteria commonly used in RCTs of alcohol use disorders, whereas, Okuda et al (2) found that as many as 80% of patients with cannabis dependence would be excluded by the commonly used eligibility criteria for cannabis treatment RCTs. A recent review study by Moberg and Humphreys (13) estimated that commonly used exclusion criteria in SUD trials would exclude between 64% and 95% of potential participants.…”

Section: Introductionmentioning

confidence: 99%

Generalizability of findings from randomized controlled trials: application to the National Institute of Drug Abuse Clinical Trials Network

et al. 2017

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Aims To compare randomized controlled trial (RCT) sample treatment effects with the population effects of substance use disorder (SUD) treatment. Design Statistical weighting was used to re-compute the effects from ten RCTs such that the participants in the trials had characteristics that resembled those of patients in the target populations. Settings Multi-site RCTs and usual SUD treatment settings in the USA. Participants A total of 3,592 patients in ten RCTs and 1,602,226 patients from usual SUD treatment settings between 2001 and 2009. Measurements Three outcomes of SUD treatment were examined: retention, urine toxicology, and abstinence. We weighted the RCT sample treatment effects using propensity scores representing the conditional probability of participating in RCTs. Findings Weighting the samples changed the significance of estimated sample treatment effects. Most commonly, positive effects of trials became statistically non-significant after weighting (three trials for retention and urine toxicology, and one trial for abstinence); but also, non-significant effects became significantly positive (one trial for abstinence), and significantly negative effects became non-significant (two trials for abstinence). There was suggestive evidence of treatment effect heterogeneity in subgroups that are under- or over-represented in the trials, some of which were consistent with the differences in average treatment effects between weighted and unweighted results. Conclusions The findings of randomized controlled trials (RCTs) for substance use disorder treatment do not appear to be directly generalizable to target populations when the RCT samples do not adequately reflect the target populations and there is treatment effect heterogeneity across patient subgroups.

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“…New definitions (ASMM, 2011) have replaced those created in the last century, centered on twelve step understanding, which emphasizes powerlessness [6]. Today's cutting edge perspective utilizes concepts of powerfulness in taking responsibility for recovery, initiating life style change, creating health and wellbeing [7,8].…”

Section: Introductionmentioning

confidence: 99%

Integrating the Science of Addiction and the Science of Wellbeing

Gilley¹

2017

J Alcohol Drug Depend

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A gap between public understanding, cutting edge brain science and the practice of addiction treatment has created hardship for those suffering. New perspective replaces the term addiction with the new concept of a continuum of substance use. Substance Use Disorder (SUD) is now regarded as a manifestation of Reward Deficiency Syndrome, which contributes to a spectrum of disorders related to genetic polymorphisms, especially in regard to impulsive, addictive and compulsive behaviors. The new brain science of addiction requires neurological medical intervention and novel treatment with nutraceuticals, the building blocks of neurotransmission. Innovative alterative holistic and wellness therapies are proving to be beneficial in helping the sufferer thrive despite chronic neurological challenge.

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Exclusion criteria in treatment research on alcohol, tobacco and illicit drug use disorders: A review and critical analysis

Cited by 32 publications

References 32 publications

Extended‐release injectable naltrexone for opioid use disorder: a systematic review

Extended‐release injectable naltrexone for opioid use disorder: a systematic review

Generalizability of findings from randomized controlled trials: application to the National Institute of Drug Abuse Clinical Trials Network

Integrating the Science of Addiction and the Science of Wellbeing

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