Evolution of the substance use landscape: Implications for contingency management.

Contingency management (CM), which involves the delivery of incentives upon meeting behavioral goals, has the potential to improve substance use treatment outcomes. The intervention allows for flexibility through numerous modifiable components including changes to incentive magnitude and schedule, target behavior, and intervention structure. Unfortunately, numerous changes in the substance use landscape have occurred in the past 10 to 15 years: Substances are more potent, overdose risk has increased, new substances and methods of use have been introduced, and substance classes are increasingly being intentionally and unintentionally mixed.

Using the novel functional purchase task to examine prescription stimulant drug effect preferences in college students.

Nonmedical prescription stimulant use (NMPSU) is a rising trend among college-age adults (18-25 years old). Survey research has identified several reasons for use, including enhancing cognitive, athletic, and social performance. Less is known about how relative reinforcing value differs based on the self-reported reasons for use.

Beliefs related to health care incentives: Comparison of substance use disorder treatment providers, medical treatment providers, and a public sample.

This study surveyed substance use disorder (SUD) treatment providers, medical treatment providers, and a public sample about beliefs regarding health care incentives to explore differences among the groups and across health disorders for which research has demonstrated incentives improve outcomes. Six hundred participants (n = 200/group) completed the Provider Survey of Incentives. The study found between group differences for positive and negative beliefs.

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions.

Introduction: Contingency management interventions are among the most efficacious psychosocial interventions in promoting abstinence from smoking, alcohol and substance use. The aim of this study was to assess the beliefs and objections towards contingency management among patients in UK-based drug and alcohol services to help understand barriers to uptake and support the development and implementation of these interventions.

Methods: The Service User Survey of Incentives was developed and implemented among patients (N = 181) at three UK-based drug and alcohol treatment services.

Parental Identification and Response to Adolescent Substance Use and Substance Use Disorders.

Previous research showing that parents tend to underestimate adolescent substance use is consistent with concerns that adolescent substance use may develop because parents delay in reacting to it. However, little research has examined parental decisions regarding how and when to intervene on adolescent substance use. This study examines the actions that parents report they would take after a) discovering substance use to intoxication and b) when they believe their child has a substance use problem.

Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient?

Community Reinforcement and Family Training (CRAFT) assists family members with a treatment-resistant loved one. The most consistent outcome of CRAFT is increased treatment entry of the identified treatment-resistant person (IP). This led us to question whether all 6 components of CRAFT are necessary.

Incentive-based Intervention to Maintain Breastfeeding Among Low-income Puerto Rican Mothers.

Background And Objective: Despite maternal and child health benefits, breastfeeding rates are relatively low among low-income Puerto Rican mothers. This study examined the hypothesis that monthly financial incentives would significantly increase the proportion of breastfeeding mothers at 6 months postpartum compared with Supplemental Nutrition Program for Women, Infants, and Children (WIC) services only among Puerto Rican mothers.

Methods: A randomized, 2-arm parallel-group design, from February 2015 through February 2016.

Examining multi-session brief intervention for substance use in primary care: research methods of a randomized controlled trial.

Background: Brief interventions such as Screening, a single session of Brief Intervention, and Referral to Treatment (SBIRT) have shown mixed effectiveness in primary care. However, there are indications that multi-session brief interventions may demonstrate more consistently positive outcomes, and perhaps a more intensive approach would be of benefit in addressing substance use in primary care. This study compared the effectiveness of SBIRT with a single BI session (BI/RT) to a multi-session brief-treatment intervention (BI/RT+) in primary care.

Implementation of a Brief Treatment Counseling Toolkit in Federally Qualified Healthcare Centers: Patient and Clinician Utilization and Satisfaction.

Introduction: The need to integrate behavioral health care within medical settings is widely recognized, and integrative care approaches are associated with improved outcomes for a range of disorders. As substance use treatment integration efforts expand within primary care settings, training behavioral health providers in evidence-based brief treatment models that are cost-effective and easily fit within the medical flow is essential.

Methods: Guided by principles drawn from Diffusion of Innovations theory (Rogers, 2003) and the Consolidated Framework of Implementation Research (Damschroder et al.

Characteristics of Low-income Racial/Ethnic Minority Pregnant Women Screening Positive for Alcohol Risk.

The current study examined the prevalence and characteristics associated with alcohol risk among low-income, predominantly racial/ethnic minority pregnant women in an urban area. We surveyed 225 pregnant women receiving nutritional care. Twenty-six percent screened positive for alcohol risk.

Introduction to Special Issue: Translational Research to Help Parents Respond to Adolescent Substance Use Problems.

Parents experience a variety of challenges when they are confronted with the fact that their adolescent child is drinking alcohol or using other substances. This special issue is focused on the work being conducted at the NIDA-funded Parents Translational Research Center (PTRC) at the Treatment Research Institute in Philadelphia. By translating scientific evidence and elements of proven clinical interventions into practical tools for parents, the work of the PTRC aims to assist parents with assistance in intervening early, finding appropriate services and facilitating treatment entry for their substance-using child.

Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents.

We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however, there are no controlled trials for parents with a substance-abusing child. We examined the behavioral parent training literature to guide us in tailoring CRAFT for parents of adolescents.

What Can Parents Do? A Review of State Laws Regarding Decision Making for Adolescent Drug Abuse and Mental Health Treatment.

This study examined US state laws regarding parental and adolescent decision-making for substance use and mental health inpatient and outpatient treatment. State statues for requiring parental consent favored mental health over drug abuse treatment and inpatient over outpatient modalities. Parental consent was sufficient in 53%-61% of the states for inpatient treatment, but only for 39% - 46% of the states for outpatient treatment.

The availability and depiction of synthetic cathinones (bath salts) on the Internet: Do online suppliers employ features to maximize purchases?

Background: "Bath salts", a derivative of cathinone, a naturally occurring beta-ketone amphetamine analogue found in the leaves of the khat (Catha edulis) plant, is a potent class of designer drugs associated with significant medical and psychiatric consequences. They are commonly used among 20-29 year olds, a group with easy access to the Internet and an inclination to purchase online. Therefore, the Internet has the potential to play a significant role in the distribution and associated consequences of these "legal highs".

Social adjustment of women with and without a substance-abusing partner.

Little normative information is available about the psychosocial functioning of women who have a substance-abusing intimate partner. This study examined whether the social adjustment of women who indicate that they have a substance-abusing partner (n=69) is compromised relative to that of women who indicate that their partner does not abuse substances (n=68). Women with a substance-abusing partner reported compromised social adjustment relative to a comparison sample both overall and in five of six life domains (work, social/leisure, primary relationship, parental, family).

A review of guidelines on home drug testing web sites for parents.

Objectives: To update and extend prior work reviewing Web sites that discuss home drug testing for parents, and assess the quality of information that the Web sites provide, to assist them in deciding when and how to use home drug testing.

Methods: We conducted a worldwide Web search that identified 8 Web sites providing information for parents on home drug testing. We assessed the information on the sites using a checklist developed with field experts in adolescent substance abuse and psychosocial interventions that focus on urine testing.

Providing alcohol for underage youth: what messages should we be sending parents?

Objective: There have been conflicting findings in the literature concerning the risks to adolescents when parents provide them with alcohol. Studies have examined various ways in which parents directly affect adolescent alcohol consumption through provision (e.g.

Contingency management for cocaine treatment: cash vs. vouchers.

The efficacy of contingency management (CM) for treating drug abuse is well supported. The most widely used form of CM is voucher-based reinforcement therapy (VBRT), where clients receive an escalating schedule of vouchers that can be redeemed for goods and services for meeting treatment goals. Though generally rejected due to concerns about potential harms to drug using participants, research suggests that cash may be a more effective reinforcer.

The RoadMAP Relapse Prevention Group Counseling Toolkit™: counselor adherence and competence outcomes.

Training counselors in empirically supported treatments (ESTs) far exceeds the ever decreasing resources of community-based treatment agencies. The purpose of this study was to examine outpatient substance abuse group counselors' (n=19) adherence and competence in communicating and utilizing concepts associated with empirically-supported relapse prevention treatment following a brief multimedia toolkit (RoadMAP Toolkit™) training. Moderate or large baseline to post-training effect sizes for counselor adherence to toolkit content were identified for 13 of 21 targeted behaviors (overall d range=.

Randomized clinical trial examining duration of voucher-based reinforcement therapy for cocaine abstinence.

Background: This is the first study to systematically manipulate duration of voucher-based reinforcement therapy (VBRT) to see if extending the duration increases abstinence during and following VBRT.

Methods: We randomized cocaine-dependent methadone-maintained adults to Standard (12 weeks; n=62) or Extended (36 weeks; n=68) VBRT and provided escalating voucher amounts contingent upon urinalysis verification of cocaine abstinence. Urinalysis was scheduled at least every 2 weeks during the 48-week study and more frequently during VBRT (3/week) and 12 weeks of Aftercare (2/week).

Psychometric assessment of a self-administered version of the Significant Other Survey.

While there are a number of general measures that assess interpersonal and psychological distress experienced by individuals who are in a close relationship with a substance abusing adult, until recently the field has lacked a psychometrically sound, self-administered multidimensional measure explicitly designed to measure the problems of non-substance-abusing adults who are concerned about a substance using loved one. This study examined the psychometric properties of a 54-item, self-administered (SA) version of the Significant Other Survey (SOS), a measure designed to address this gap. The SOS-SA assesses problems across seven problem domains (emotional, relationship, family, financial, physical violence, legal, health).

Developing an evidence-based, multimedia group counseling curriculum toolkit.

Training community-based addiction counselors in empirically supported treatments (ESTs) far exceeds the ever-decreasing resources of publicly funded treatment agencies. This feasibility study describes the development and pilot testing of a group counseling toolkit (an approach adapted from the education field) focused on relapse prevention (RP). When counselors (N = 17) used the RP toolkit after 3 hours of training, their content adherence scores on "coping with craving" and "drug refusal skills" showed significant improvement, as indicated by very large effect sizes (Cohen's d = 1.

Is exposure to an effective contingency management intervention associated with more positive provider beliefs?

This study empirically examined opinions of treatment providers regarding contingency management (CM) programs while controlling for experience with a specific efficacious CM program. In addition to empirically describing provider opinions, we examined whether the opinions of providers at the sites that implemented the CM program were more positive than those of matched providers at sites that did not implement it. Participants from 7 CM treatment sites (n = 76) and 7 matched nonparticipating sites (n = 69) within the same nodes of the National Institute of Drug Abuse Clinical Trials Network completed the Provider Survey of Incentives (PSI), which assesses positive and negative beliefs about incentive programs.