Capturing the Full Range of Buprenorphine Treatment Response.

Importance: Reliance on abstinence-based treatment success rules may fail to capture the full continuum of treatment response to buprenorphine plus medical counseling (BUP+MC) for opioid use disorder (OUD).

Objective: To describe patterns of reduction in illicit opioid use of patients both labeled as a success and nonsuccess based on an abstinent-based treatment outcome rule.

Design, Setting, And Participants: This study is a secondary data analysis of 4 harmonized randomized clinical trials on BUP+MC for OUD from multiple sites that included 869 patients with OUD.

Comparing the psychometric properties of reward and relief drinking measures.

Previous work examining the extent to which individuals seek alcohol to enhance positive experiences (reward drinking) or relieve aversive states (relief drinking) has shown that reward/relief drinking predicts response to naltrexone and acamprosate treatment for alcohol use disorder. Yet, various measures of reward/relief drinking have been used in prior research, and the comparative psychometric properties of these measures are unknown. Evaluating and comparing the psychometric properties of these reward/relief drinking measures could identify measures with the most promise for translating precision medicine findings to clinical practice.

Examining cocaine use reductions and long-term outcomes in two clinical trials of continuing care for cocaine dependence.

Background: There is a need to identify clinically meaningful non-abstinent endpoints for cocaine use disorder (CUD) clinical trials. In this study, we sought to replicate and extend prior work validating reductions in cocaine use frequency levels as an endpoint by examining associations between reductions in cocaine use frequency and long-term functioning outcomes.

Methods: We conducted a secondary analysis of two randomized clinical trials (N = 445; 77.

Cognitive behavioral therapy for anxiety and opioid use disorder: Development and pilot testing.

Introduction: Anxiety disorders are highly prevalent among people with opioid use disorder (OUD), and they have a negative impact on disorder course and treatment outcomes. The objective of this Stage 1 A/1B behavioral treatment development trial was to develop a novel cognitive-behavioral therapy (CBT) protocol for co-occurring anxiety disorders and OUD.

Methods: Following a period of iterative manual development involving patient interviews and feedback from content experts, we tested a 12-session individual CBT protocol in a small, open pilot trial (N = 5).

Longitudinal measurement invariance of constructs derived from the addiction cycle.

Objective: The Alcohol Addiction Research Domain Criteria (AARDoC) is an organizational framework for assessing heterogeneity in addictive disorders organized across the addiction cycle domains of incentive salience, negative emotionality, and executive functioning and may have benefits for precision medicine. Recent work found pretreatment self-report items mapped onto the addiction cycle domains and predicted 1- and 3-year alcohol use disorder treatment outcomes. Given the potential utility of the addiction cycle domains for predicting relevant treatment outcomes, this study sought to evaluate the longitudinal measurement invariance of the domains.

Association Between Religious Salience and Past-Year Substance Use by Sexual Identity and Sex Among Adults in the United States.

We examined if associations between religious salience and substance use outcomes differed by sexual identity and sex in a nationally representative sample of adults in the United States. Using data from the 2019 National Survey on Drug Use and Health ( = 41,216 adults), logistic regression models tested whether sexual identity and sex moderated the associations between religious salience (agreement on the importance of religious beliefs) and past-year alcohol and drug use and use disorders. Religious salience reduced risk of alcohol use disorder, drug use, and drug use disorder for heterosexual, but not lesbian, gay, and bisexual (LGB), individuals.

Alcohol use disorder conceptualizations and diagnoses reflect their sociopolitical context.

The present paper highlights how alcohol use disorder (AUD) conceptualizations and resulting diagnostic criteria have evolved over time in correspondence with interconnected sociopolitical influences in the United States. We highlight four illustrative examples of how DSM-defined alcoholism, abuse/dependence, and AUD have been influenced by sociopolitical factors. In doing so, we emphasize the importance of recognizing and understanding such sociopolitical factors in the application of AUD diagnoses.

Defining Prescription Drug Misuse: A Naturalistic Evaluation of National Survey on Drug Use and Health Data From 2012-2014 to 2015-2017.

Objectives: Prescription drug misuse (PDM) is a significant public health problem. As research has evolved, the definitions of misuse have varied over time, yet the implications of this variability have not been systematically studied. The objective of this study was to leverage a change in the measurement of PDM in a large population survey to identify its impact on the prevalence and correlates of this behavior.

Examining Associations Between Negative Affect and Substance Use in Treatment-Seeking Samples: A Review of Studies Using Intensive Longitudinal Methods.

Purpose Of Review: Understanding dynamic relationships between negative affect and substance use disorder (SUD) outcomes, including craving, may help inform adaptive and personalized interventions. Recent studies using intensive longitudinal methods were reviewed to examine relationships between negative affect and the outcomes of either craving or substance use during and following SUD treatment.

Recent Findings: Results on associations between negative affect and craving/substance use were mixed and difficult to synthesize, given methodological differences across studies.

Prevalence and correlates of the misuse of z-drugs and benzodiazepines in the National Survey on Drug Use and Health.

Background: Benzodiazepines and non-benzodiazepine hypnotics (z-drugs) are commonly prescribed for their anxiolytic and hypnotic properties, though they can also be misused. In studies examining the epidemiology of prescription drug misuse, these medication classes are commonly combined, rendering inadequate knowledge of their patterns of misuse. The objective of this study was to characterize the population prevalence, conditional dependence, and sociodemographic and clinical correlates of the misuse of benzodiazepines and z-drugs.

A clinical science guide for reviewing the cross-cultural rigor of assessments in an alcohol training clinic.

A standard component of service delivery in alcohol treatment clinics is evidence-based assessment (EBA). Although EBA is essential for selecting appropriate treatment modalities for alcohol use and associated problems, there are limitations in existing EBAs concerning evidence of cultural equivalence and utility among individuals seeking alcohol treatment. However, training in EBA, addictions, and clinical applications with diverse populations all are gaps in clinical training in doctoral programs in clinical psychology.

An intensive longitudinal examination of topiramate treatment for alcohol use disorder: a secondary analysis of data from a randomized controlled trial.

Background And Aims: Previous findings have been equivocal as to whether a single-nucleotide polymorphism (rs2832407) in GRIK1, which encodes a glutamate receptor subunit, moderates the effects of topiramate treatment for drinking reduction. We leveraged intensive longitudinal data to provide greater precision and allow an examination of intermediate outcomes addressing this question. We used data from a randomized controlled trial (RCT) to test the hypotheses that topiramate treatment reduces daily heavy drinking, desire to drink and positive alcohol expectancies and that these effects are stronger in rs2832407*C-allele homozygotes.

Constructs derived from the addiction cycle predict alcohol use disorder treatment outcomes and recovery 3 years following treatment.

Objective: The addiction cycle has been proposed as a framework for understanding the progression of alcohol use disorder (AUD) in terms of psychological and biological domains, including reward drinking/incentive salience, relief drinking/negative emotionality, and loss of control/executive functioning impairment. To have utility in clinical practice, self-report measures of these domains that are applicable across sociodemographic groups and associated with clinical outcomes are needed. This study sought to validate domains from self-report measures and to test whether domains are measurement invariant across sociodemographic groups and associated with treatment outcomes.

Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault Among College Women With Higher Sexual Risk Alcohol Expectancies.

Objective: College women report high rates of sexual assault. Research focused on women's risk factors for sexual assault remains necessary to assist women in reducing their risk. Previous work has shown alcohol use and cannabis use to be associated with sexual assault.

Transcranial Direct Current Stimulation Provides no Additional Benefit to Improvements in Self-Reported Craving Following Mindfulness-Based Relapse Prevention.

Objectives: Mindfulness-Based Relapse Prevention (MBRP) and transcranial direct current stimulation (tDCS) have each demonstrated efficacy in improving outcomes in those with alcohol use disorder (AUD), however a recent study that combined MBRP with tDCS found tDCS provided no additional benefit to MBRP for AUD. Differences in treatment adherence between active versus sham tDCS groups may have contributed to this result. The current study examined whether treatment adherence interacted with tDCS condition in predicting post-treatment mindfulness and craving.

Examining a brief measure and observed cutoff scores to identify reward and relief drinking profiles: Psychometric properties and pharmacotherapy response.

Background: Precision medicine approaches attempt to reduce variability in alcohol use disorder (AUD) outcomes by identifying patient characteristics that predict response to a particular treatment. Recent work has examined the extent to which individuals with AUD may seek alcohol to enhance positive experiences (reward drinking) or relieve negative states (relief drinking) and shown that a high reward/low relief phenotype predicts naltrexone treatment response. Yet, limitations of reward/relief drinking measures may hamper efforts to translate findings to clinical practice.

Motives for Substance Use in Daily Life: A Systematic Review of Studies Using Ecological Momentary Assessment.

The motivational model of substance use posits four motive subtypes (coping, enhancement, social, conformity) dynamically interact with contextual factors to impact decisions about substance use. Yet, prior studies assessing the motivational model have relied on between-person, cross-sectional evaluations of trait motives. We systematically reviewed ecological momentary assessments (EMA) studies (=64) on motives for substance use to examine: methodological features of EMA studies examining the motivational model, support for the motivational model between and within individuals, and associations between trait motives and daily processes.

The Role of Affect in Psychosocial Treatments for Substance Use Disorders.

Purpose Of Review: This paper provides a narrative review of studies published over the past five years that have examined the role of affect, including both affective symptoms and affective disorders, in psychosocial treatments for substance use disorder.

Recent Findings: A growing body of literature suggests that affective symptoms and affective disorders may moderate substance use disorder treatment efficacy, mediate the effects of treatment on substance use outcomes, and may be directly changed by substance use disorder treatment.

Summary: Substance use disorders and affective disorders commonly co-occur, and both affect and affective disorders are associated with substance use disorder treatment outcomes.

A Longitudinal Mediation Model of Negative Emotionality, Coping Motives and Drinking Intensity Among Individuals Receiving Community Treatment for Alcohol Use Disorder.

Aims: Negative emotionality is a key domain in frameworks measuring heterogeneity in alcohol use disorder (AUD), such as the Addictions Neuroclinical Assessment (ANA). Recent research has examined the construct validity of the ANA negative emotionality domain, but has not examined whether this domain demonstrates predictive validity for drinking outcomes. In this study, we examined the association between self-reported negative emotionality at baseline and drinking intensity 1 year following AUD treatment initiation.

Validity and measurement invariance of the Addictions Neuroclinical Assessment incentive salience domain among treatment-seekers with alcohol use disorder.

Incentive salience, or the attribution of motivational value to stimuli, is a biopsychological process that is disrupted in alcohol use disorder (AUD). The Addictions Neuroclinical Assessment (ANA) is a framework to characterize heterogeneity in addiction and establish a common assessment battery for research and clinical use. The ANA framework hypothesizes three constructs that correspond to processes in the etiology, course, and treatment of addiction: incentive salience, negative emotionality, and executive function.

Can Individuals With Alcohol Use Disorder Sustain Non-abstinent Recovery? Non-abstinent Outcomes 10 Years After Alcohol Use Disorder Treatment.

Objective: Four decades ago, the "controlled drinking" controversy roiled the alcohol field. Data have subsequently accumulated indicating that nonabstinent alcohol use disorder (AUD) recovery is achievable, but questions remain whether it is sustainable long-term. This study examined whether nonabstinent recovery at 3 years after AUD treatment is associated with better functioning at 10 years after treatment.