Alcohol Clin Exp Res (Hoboken)
September 2024
Background: Many individuals with excessive alcohol consumption desire moderation but do not seek formalized treatment. Commercially available, technology-assisted options are flexible and highly accessible, yet often not empirically validated.
Methods: Individuals desiring alcohol moderation (age 21+) self-selected to use Sunnyside®, a web application with tailored and adaptive text messaging.
Background: There is a lack of consensus in the addiction field as to how to refer to alumni of residential treatment who no longer use substances or who reduce their use. In the literature, this label and broader identity are typically discussed in technical (amount and frequency of use) or social terms (environment and social network changes).
Objective: The current paper seeks to simplify the discussion by focusing on personal labels without complex technical or social considerations.
Effective translation of data to inform real-time patient care is lacking in addiction inpatient settings. The current study presents the optimization of an assessment report that is used by clinicians to individualize treatment. A multi-aim, iterative approach was taken, utilizing an implementation science perspective to arrive at a final version of the assessment report.
View Article and Find Full Text PDFAims: To test differential outcomes between three 6-month text-messaging interventions to reduce at-risk drinking in help-seeking adults.
Design: A three-arm single-blind randomized controlled trial with 1-, 3-, 6- and 12-month follow-ups.
Setting: United States.
Background: Quality training is an oft-cited barrier to effective implementation and ongoing delivery of high-quality evidence-based practice (EBP) across fields. This is especially true in the addiction field, but there is little cited evidence for optimal methods to improve EBP in inpatient addiction facilities with minimal resources.
Objective: The current paper focuses on evaluating the state of our facility's group CBT manual and clinical training on the manual in a "realistic" (ie, non-RCT, non-grant-funded) inpatient addiction treatment setting.
Drug Alcohol Depend Rep
March 2022
Introduction: Individuals with alcohol use disorder (AUD) who seek help to reduce their drinking are expected to vary with respect to drinking goal, with some choosing abstinence and others moderation. The present research explored whether drinking goals vary day to day among individuals with AUD planning to enter treatment and the relationship of specific daily goals to actual drinking behavior in daily life.
Methods: Participants were 153 individuals with AUD who enrolled in a study of stepped care brief interventions and completed smartphone momentary assessments in daily life.
Background: The widespread shift from in-person to Telehealth services during the Covid-19 pandemic irreversibly shifted the landscape of outpatient substance use treatment. This shift was necessitated by health, rather than data-driven, reasons. As we reflect on whether to continue providing Telehealth services moving forward, we require empirical support on the effectiveness of Telehealth services (compared to in-person services) in terms of patient outcomes, such as Quality of Life (QOL), to support this decision.
View Article and Find Full Text PDFThe profound economic burden of schizophrenia is due, in part, to the negative symptoms of the disease, which can severely limit daily functioning. There is much debate in the field regarding their measurement and classification and there are no FDA-approved treatments for negative symptoms despite an abundance of research. 3,4-Methylenedioxy methamphetamine (MDMA) is a schedule I substance that has emerged as a novel therapeutic given its ability to enhance social interactions, generate empathy, and induce a state of metaplasticity in the brain.
View Article and Find Full Text PDFOne potential medication for treating methamphetamine use disorder is the opioid antagonist naltrexone (NLTX). Despite encouraging preclinical findings, the results of clinical studies have been mixed. The primary aim of the current trial was to examine the effects of acute NLTX pretreatment on the subjective and reinforcing effects of intranasal methamphetamine.
View Article and Find Full Text PDFObjective: Some adverse cannabis effects are greater in individuals on the psychosis spectrum compared to healthy individuals. We have previously reported that smoked cannabis acutely worsened psychotic- like states and reduced cognitive performance selectively in cannabis users at clinical high-risk (CHR) for psychosis. The objective of the present study was to further investigate the acute effects of cannabis on cognition and reward processing in CHR cannabis users.
View Article and Find Full Text PDFBackground: Adaptive interventions, sometimes referred to as "stepped care", are those interventions in which the type or dosage of treatment offered to patients is tailored to baseline clinical presentation and then adjusted over time in response to patient progress or lack thereof. Currently, no adaptive brief interventions exist specifically for alcohol use disorder (AUD).
Method: This study used a sequential multiple assignment randomized trial design with 160 individuals with AUD recruited both locally and nationally who had a goal to reduce or abstain from drinking.
Background: The classic Marshmallow Test, where children were offered a choice between one small but immediate reward (eg, one marshmallow) or a larger reward (eg, two marshmallows) if they waited for a period of time, instigated a wealth of research on the relationships among impulsive responding, self-regulation, and clinical and life outcomes. Impulsivity is a hallmark feature of self-regulation failures that lead to poor health decisions and outcomes, making understanding and treating impulsivity one of the most important constructs to tackle in building a culture of health. Despite a large literature base, impulsivity measurement remains difficult due to the multidimensional nature of the construct and limited methods of assessment in daily life.
View Article and Find Full Text PDFIntroduction And Aims: Impulsivity may be a risk factor that increases vulnerability to nicotine dependence. However, nicotine exposure itself may directly increase impulsivity. This is a secondary analysis of the first study in a controlled laboratory setting, which assessed the effects of nicotine administration (acute and repeated) and exposure to smoking cues on behavioural impulsivity in humans (ClinicalTrials.
View Article and Find Full Text PDFEur J Nucl Med Mol Imaging
September 2020
Background: Lithium, one of the few effective treatments for bipolar depression (BPD), has been hypothesized to work by enhancing serotonergic transmission. Despite preclinical evidence, it is unknown whether lithium acts via the serotonergic system. Here we examined the potential of serotonin transporter (5-HTT) or serotonin 1A receptor (5-HT) pre-treatment binding to predict lithium treatment response and remission.
View Article and Find Full Text PDFMany individuals with alcohol use disorder (AUD) prefer a goal of moderation, because they do not see their drinking as causing severe enough consequences to merit abstinence. Given that individuals attempting to moderate will continue to put themselves in contexts where drinking occurs, understanding how distinct external alcohol cues prompt craving is important for implementing the optimal treatments for individuals with AUD. Using data from a randomized controlled trial of stepped care brief interventions for AUD, this study explored the relationship between drinking contexts and craving in individuals attempting to moderate their drinking using ecological momentary assessment (EMA).
View Article and Find Full Text PDFObjective: This study examined learning functions in short-term cocaine users and control participants.
Method: Seventeen active cocaine users (reporting 3.5 mean years of cocaine use) and seventeen non-cocaine-using controls (with similar reported levels of alcohol and marijuana use) were compared on tasks measuring different aspects of learning.
Background: Little is known about the functional status of older drug users, who may pose challenges to public health systems in coming years. Here, we assessed cognitive function in aging cocaine smokers compared to demographically matched controls.
Methods: A total of 22 non-treatment-seeking aging (50-60 years old) cocaine smokers (⩾twice/week; ⩾15 years of weekly use) and 19 controls completed a comprehensive cognitive battery.
Illicit drug use among aging cohorts is increasing, yet little is known about functional impairments in older drug users. Given the importance of social integration for aging and documented social decrements in cocaine users, we examined social function and its neurocognitive substrates in aging cocaine users relative to carefully matched non-cocaine users. Regular (≥twice/week), long-term (≥15 years) cocaine smokers 50-60 years old (COCs; n = 22; four women) and controls (CTRLs; n = 19; four women) underwent standardized probes of social reward and threat processing during functional magnetic resonance imaging and a behavioral facial affect recognition task.
View Article and Find Full Text PDFMarijuana use is associated with psychosis, but its effects are understudied in individuals with preexisting risk for psychotic disorders. This preliminary study examined the acute psychological and physiological effects of smoked marijuana (0.0% or 5.
View Article and Find Full Text PDFJ Clin Exp Neuropsychol
August 2016
Drug addiction is a chronic relapsing disorder characterized by compulsive drug seeking and continued use despite negative consequences. Behavioral impulsivity is a strong predictor of the initiation and maintenance of drug addiction. Preclinical data suggest that heroin may exacerbate impulsive characteristics in an individual but this has yet to be assessed in clinical samples.
View Article and Find Full Text PDFIn addition to difficulties in daily social functioning, regular cocaine users have decrements in social processing (the cognitive and affective processes underlying social behavior) relative to non-users. Little is known, however, about the effects of clinically-relevant pharmacological agents, such as cocaine and potential treatment medications, on social processing in cocaine users. Such drug effects could potentially alleviate or compound baseline social processing decrements in cocaine abusers.
View Article and Find Full Text PDFWhile substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences.
View Article and Find Full Text PDFHuman drug use involves repeated choices to take drugs or to engage in alternative behaviors. The purpose of this study was to examine how response cost for cocaine and the value of an alternative reinforcer (opportunity to play a game of chance) and how 'free' doses (with minimal response cost) affected cocaine choice. Two laboratory studies of cocaine self-administration were conducted in a group of humans who were habitual cocaine smokers and in a group of rhesus monkeys that intravenously self-administered cocaine.
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