Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users

Klimas, Jan; Tobin, Helen; Field, Catherine Anne; O’Gorman, Clodagh S.; Glynn, Liam; Keenan, Eamon; Saunders, Jean; Bury, Gerard; Dunne, Colum P.; Cullen, William R.

doi:10.1002/14651858.cd009269.pub3

Cited by 49 publications

(23 citation statements)

References 90 publications

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“…The data for treating alcohol use disorders, however, is still emerging. A systematic review of several types of psychosocial interventions (i.e., cognitive-behavioral coping skills, brief interventions, motivational interviewing, and hepatitis health promotion) found little support for their use in reducing alcohol consumption [97]. Though several pharmacological interventions (e.g., naltrexone, acamprosate) have reduced several outcomes associated with alcohol consumption (time to relapse, number of heavy or any drinking days, etc.)…”

Section: Discussionmentioning

confidence: 99%

The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review

et al. 2015

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Alcohol use is highly prevalent globally with numerous negative consequences to human health, including HIV progression, in people living with HIV (PLH). The HIV continuum of care, or treatment cascade, represents a sequence of targets for intervention that can result in viral suppression, which ultimately benefits individuals and society. The extent to which alcohol impacts each step in the cascade, however, has not been systematically examined. International targets for HIV treatment as prevention aim for 90 % of PLH to be diagnosed, 90 % of them to be prescribed with antiretroviral therapy (ART), and 90 % to achieve viral suppression; currently, only 20 % of PLH are virally suppressed. This systematic review, from 2010 through May 2015, found 53 clinical research papers examining the impact of alcohol use on each step of the HIV treatment cascade. These studies were mostly cross-sectional or cohort studies and from all income settings. Most (77 %) found a negative association between alcohol consumption on one or more stages of the treatment cascade. Lack of consistency in measurement, however, reduced the ability to draw consistent conclusions. Nonetheless, the strong negative correlations suggest that problematic alcohol consumption should be targeted, preferably using evidence-based behavioral and pharmacological interventions, to indirectly increase the proportion of PLH achieving viral suppression, to achieve treatment as prevention mandates, and to reduce HIV transmission.

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Section: Discussionmentioning

confidence: 99%

The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review

et al. 2015

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“… 10 - 14 Notably, baclofen has been the only medication to be studied in AUD patients with cirrhosis. Although it is clear that a combined treatment approach with behavioral therapy is the optimal strategy, 15 pharmacotherapy is a vital component. 16 …”

Section: Introductionmentioning

confidence: 99%

Practice Habits, Knowledge, and Attitudes of Hepatologists to Alcohol Use Disorder Medication: Sobering Gaps and Opportunities

Cotter

Ayoub

King

et al. 2020

Transplantation Direct

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Background: The prevalence of alcohol use disorder (AUD) and alcohol-associated liver disease is increasing in the United States. Efficacious AUD pharmacotherapies, while available, are, for protean reasons, underutilized. Hepatology providers may be in a position to bridge the pharmacotherapeutic gap between availability and utilization of AUD pharmacotherapies. Our aim was to ascertain the current practice, knowledge and attitudes of hepatology physicians in the United States, and identify opportunities on how to increase AUD medication prescribing. Methods: A web-based survey, developed by an expert panel, was administered to hepatology physicians working at all transplant centers in the United States. Results: The survey response rate was 131/658 (20%). There was significant support (two-thirds of respondents) for hepatology providers prescribing AUD medications; however, only 1 in 4 was comfortable prescribing these medications. The majority felt additional education is needed to prescribe AUD medications. The practice of hepatology providers prescribing AUD medications is common, with >50% of respondents having done so. Baclofen was the most popular medication prescribed. Hepatology providers perceived suboptimal ancillary addiction services. Although AUD prescribers had higher rates of AUD pharmacotherapy knowledge compared with nonprescribers, approximately 50% still had inadequate knowledge. Conclusions: AUD medication prescribing is a common practice among hepatology providers who appear eager to increase this practice through more education as they attempt to bridge the pharmacotherapeutic gap. This informative survey provides guidance for professional societies on how best to disseminate the requisite education required to optimize the care of patients with AUD.

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“…Although there is some evidence that specific psychosocial interventions (e.g. Cognitive behavioral therapy; [ 5 ]) can reduce problems in patients with single substance use without psychiatric comorbidity, there is limited evidence to support any one intervention over another in the treatment of polysubstance abuse with psychiatric comorbidity [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Alcoholism has been described at least since the ancient Greek and Roman times [ 8 ]. A wide variety of treatments for alcohol and drug use problems have been tried and are used in the standard care of patients with substance use problems, both pharmacological and psychological [ 5 – 7 , 9 , 10 ]. Several alternative treatments have also been tried, e.g.…”

Section: Introductionmentioning

confidence: 99%

Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services

Ahlberg

Skårberg

Brus

et al. 2016

Subst Abuse Treat Prev Policy

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BackgroundA common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.MethodOf the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η2), and Wilcoxon Signed Ranks tests.ResultsParticipants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η2 = 0.03, ISI, η2 = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.ConclusionNo evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.Trial registrationClinical Trials NCT02604706 (retrospectively registered).

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Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users

Abstract: Analysis 1.1. Comparison 1 Cognitive-behavioural coping skills training (CBCST) versus twelve-step facilitation (TSF) programme, Outcome

Cited by 49 publications

References 90 publications

The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review

The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review

Practice Habits, Knowledge, and Attitudes of Hepatologists to Alcohol Use Disorder Medication: Sobering Gaps and Opportunities

Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services

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