A Protocol for Adapting a Mindfulness-Based Intervention with Contingency Management to Reduce Alcohol Misuse Among Latine Emerging Adults.

Emerging adulthood (ages 18-25 years old) is a critical period for the onset of problematic drinking, especially within underserved populations, such as Latine emerging adults. This protocol outlines the adaptation of a Mindfulness-Based Intervention (MBI) incorporating Contingency Management (CM) to address alcohol misuse in Latine young adults, a demographic with limited treatment access and increased vulnerability to substance use disorders. Grounded in Community-Engaged Research (CEnR) principles, this study employs a structured formative development approach to culturally and developmentally adapt a Mindfulness-Based Stress Reduction (MBSR) program.

Percentage of negative urine drug screens as a clinically meaningful endpoint for RCTs evaluating treatment for cocaine use.

Background: This study examined a threshold based on the percentage of cocaine-negative (CN) urine drug screens (UDS) collected during treatment as a potential meaningful endpoint for clinical trials. We hypothesized that individuals providing at least 75% CN UDS would have better long-term outcomes than those providing less than 75% CN UDS.

Methods: Two separate pooled datasets of randomized clinical trials conducted at different institutions were used for analyses: one composed of eight trials (N = 760) and the other composed of three trials (N = 416), all evaluating behavioral and/or pharmacological treatments for cocaine use.

Mindfulness as an early intervention for hazardous alcohol use among non-treatment seeking Latine emerging adults: A mini-review.

The age cohort referred to as emerging adults (ages 18-29 years old) demonstrates the most hazardous alcohol use in the United States (U.S.) Approximately one-third of emerging adults regularly engage in heavy episodic drinking (4/5 drinks in two hours females/males).

Most recent, modal, or median heroin purchase: Does it matter when estimating market size?

Background: Assessing the size of illicit drug markets is an important activity of many government agencies; however, the expenditure-based method for estimating market size relies on the relatively untested assumption that the cash value of the most recent purchase is representative of the average purchase amount. Using panel data, we test the representativeness of the most recent, modal and median purchase compared to the average purchase amount.

Methods: Data were drawn from a prior study that collected daily transaction-level purchase data from a sample of 120 people who were using heroin regularly.

Deep Brain Stimulation Compared With Contingency Management for the Treatment of Cocaine Use Disorders: A Threshold and Cost-Effectiveness Analysis.

Objectives: Cocaine is the second most frequently used illicit drug worldwide (after cannabis), and cocaine use disorder (CUD)-related deaths increased globally by 80% from 1990 to 2013. There is yet to be a regulatory-approved treatment. Emerging preclinical evidence indicates that deep brain stimulation (DBS) of the nucleus accumbens may be a therapeutic option.

Tobacco use patterns and clinical outcomes in the T1D exchange.

Aims: This study examined associations between tobacco use and diabetes outcomes using the T1D Exchange Registry.

Methods: Adult participants (N = 933) completed standardized questionnaires including self-reported outcomes: past year serious hypoglycemic and diabetic ketoacidosis episodes, diabetes self-care, diabetes distress, and self-monitoring of blood glucose. Chart-extracted outcomes included HbA1c, nephrology and neuropathy diagnoses, and BMI.

The impact of marijuana use on cocaine use outcomes among patients in methadone maintenance treatment across five trials of contingency management.

Objective: Cocaine use is prevalent among patients in methadone maintenance and a risk factor for poor treatment outcomes. Contingency management (CM) decreases cocaine use in this population, but little is known about its efficacy when marijuana use is present prior to or during treatment.

Method: Data from five randomized CM trials ( = 557) were used to evaluate whether: (a) marijuana frequency (none, low, or high) prior to or during treatment impacts cocaine use outcomes and (b) marijuana use differentially impacts cocaine outcomes with standard care (SC) + CM versus SC alone.

Alcohol Use Disorder in the Age of Technology: A Review of Wearable Biosensors in Alcohol Use Disorder Treatment.

Biosensors enable observation and understanding of latent physiological occurrences otherwise unknown or invasively detected. Wearable biosensors monitoring physiological constructs across a wide variety of mental and physical health conditions have become an important trend in innovative research methodologies. Within substance use research, explorations of biosensor technology commonly focus on identifying physiological indicators of intoxication to increase understanding of addiction etiology and to inform treatment recommendations.

Impact of 12 step mutual help groups on drug use disorder patients across six clinical trials.

Background: 12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples of drug use disorder patients.

Methods: Data from six federally-funded randomized trials were pooled (n = 1730) and subjected to two-stage instrumental variables modelling, and, fixed and random effects regression models.

Alcohol Use and Clinical Outcomes in Adults in the Type 1 Diabetes Exchange.

Objectives: Alcohol consumption has serious potential consequences for persons with type 1 diabetes. This cross-sectional study examined associations between drinking status and diabetes-related outcomes.

Methods: Participants included 934 adults at Type 1 Diabetes Exchange Registry clinics who responded to an e-mail invitation to complete an electronic survey with items on alcohol consumption; glycated hemoglobin (A1C) and body mass index (BMI) were extracted from medical charts.

Reinforcing exercise to improve drug abuse treatment outcomes: A randomized controlled study in a substance use disorder outpatient treatment setting.

Exercise holds potential to reduce substance use, but engaging patients in exercise regimens is challenging. Contingency management (CM) interventions can directly address adherence by targeting initiation and maintenance of exercise behavior. This study evaluated the efficacy of a CM-reinforced exercise intervention as an adjunct to standard outpatient substance use disorder treatment.

Examining implementation of contingency management in real-world settings.

Very little is known about how reward programs are implemented in real-world substance use treatment settings and whether training in contingency management (CM), an empirically supported rewards-based intervention, impacts their design quality. Providers ( = 214) completed surveys assessing CM beliefs, training, and practices related to use of tangible rewards in treatment. For providers reporting they had not used rewards in treatment previously (54%, = 116), we assessed beliefs about and interest in adopting a reward-based program.

Objective continuous monitoring of alcohol consumption for three months among alcohol use disorder treatment outpatients.

Background: Transdermal alcohol sensing technology allows for objective continuous monitoring of alcohol use. The purpose of this study was to characterize alcohol consumption measured with this technology among alcohol use disorder treatment outpatients in two clinical trials.

Methods: Participants were community-based alcohol treatment outpatients in usual care (N = 63) during the first three years of studies that monitored drinking with the secure continuous remote alcohol monitor (SCRAMx®) ankle bracelet.

Monitoring alcohol use in heavy drinking soup kitchen attendees.

Rates of heavy alcohol use in soup kitchen attendees range from 30% to 38%, but these data are based entirely on self-reported drinking. Little is known about the intensity or frequency of drinking in this population. We assessed alcohol use transdermally every 30 min over a 3-week period among heavy drinkers who attended local soup kitchens.

A randomized trial of contingency management reinforcing attendance at treatment: Do duration and timing of reinforcement matter?

Objective: Contingency management (CM) interventions that reinforce attendance have rarely been evaluated in terms of reducing drug use. Using a sequential randomized design, this study examined the efficacy of three attendance CM conditions compared to usual care (UC) on drug use outcomes. It evaluated whether the duration (6 vs.

A randomized trial of contingency management for smoking cessation in the homeless.

Smoking-cessation services are an unmet need among the homeless, who smoke at rates more than 4 times the national estimate. Successful interventions have high potential for improving tobacco-related health disparities among homeless smokers. Contingency management (CM) is a behavioral intervention with efficacy in a number of substance-use disorder populations, including smokers.

Experiences with SCRAMx alcohol monitoring technology in 100 alcohol treatment outpatients.

Background: Transdermal alcohol monitoring technology allows for new research on alcohol use disorders. This study assessed feasibility, acceptability, and adherence with this technology in the context of two clinical research trials.

Methods: Participants were the first 100 community-based alcohol treatment outpatients enrolled in randomized studies that monitored drinking with the secure continuous remote alcohol monitor (SCRAMx) for 12 weeks.

Contingency management treatment for substance use disorders: How far has it come, and where does it need to go?

Contingency management (CM) interventions consistently improve substance abuse treatment outcomes, yet CM remains a highly controversial intervention and is rarely implemented in practice settings. This article briefly outlines the evidence base of CM and then describes 4 of the most often-cited concerns about it: philosophical, motivational, durability, and economic. Data supporting and refuting each of these issues are reviewed.

A Randomized Trial of Adjunct mHealth Abstinence Reinforcement With Transdermal Nicotine and Counseling for Smoking Cessation.

Introduction: Abstinence reinforcement is efficacious for improving smoking treatment outcomes, but practical constraints related to the need for multiple in-person carbon monoxide (CO) breath tests daily to verify smoking abstinence have limited its use. This study tested an mHealth procedure to remotely monitor and reinforce smoking abstinence in individuals' natural environment.

Methods: Eligible treatment-seeking smokers (N = 90) were randomized to (1) usual care and ecological monitoring with abstinence reinforcement (mHealth reinforcement) or (2) without reinforcement (mHealth monitoring).

Substance Abuse Treatment Patients in Housing Programs Respond to Contingency Management Interventions.

Use of homeless and transitional housing (e.g., recovery homes) programs can be associated with success in substance abuse treatment, perhaps because many of these programs encourage or mandate sobriety.

Treatment Satisfaction in a Randomized Clinical Trial of mHealth Smoking Abstinence Reinforcement.

The importance of patient satisfaction in modern healthcare is widely recognized, but research on satisfaction in the context of smoking cessation has not kept pace. The purpose of this study was to explore treatment satisfaction in a sample of smokers (N=84) randomized to one of two smoking cessation treatment interventions (mHealth reinforcement and mHealth monitoring) that used cell phone-based procedures to monitor smoking status in individuals' natural environments for 4 weeks. Starting on the target quit date, participants received usual care smoking cessation treatment consisting of 8 weeks of transdermal nicotine and 4 weeks of twice-weekly telephone counseling were also prompted 1 to 3 times daily (with exact number and timing not disclosed beforehand) to use a study cell phone and CO monitor to complete a CO self-test, video-record the process, and submit videos using multimedia messaging within 2 hours.

A randomized controlled trial of brief interventions for problem gambling in substance abuse treatment patients.

Objective: This study evaluated the efficacy of brief gambling treatments in patients attending substance abuse treatment clinics.

Method: Substance abuse treatment patients with gambling problems (N = 217) were randomly assigned to a 10- to 15-min brief psychoeducation gambling intervention; a 10- to 15-min brief advice intervention addressing gambling norms, risk factors, and methods to prevent additional problems; or 4 50-min sessions of motivational enhancement therapy plus cognitive behavior therapy for reducing gambling (MET + CBT). Gambling and related problems were assessed at baseline and throughout 24 months.