Objectives We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients. Methods We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2008 through June 2011. We randomized participants to a control arm (n = 245) and an intervention arm (n = 244), which included on-site screening, motivational-enhanced education and counseling, on-site vaccination, and case management services. Results Compared with the control group, intervention group participants were significantly more likely (odds ratio [OR] = 41.8; 95% confidence interval [CI] = 19.4, 90.0) to receive their first vaccine dose within 30 days and to receive an HCV evaluation within 6 months (OR = 4.10; 95% CI = 2.35, 7.17). A combined intervention adherence outcome that measured adherence to HAV–HBV vaccination, HCV evaluation, or both strongly favored the intervention group (OR = 8.70; 95% CI = 5.56, 13.61). Conclusions Hepatitis care coordination was efficacious in increasing adherence to HAV–HBV vaccination and HCV clinical evaluation among methadone patients.

This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area.Accountability, constrained budgets and a growing demand for more effective services highlight the need for Evidence-Based Practices (EBPs) in addiction treatment. EBPs integrate the best available research with clinical expertise, taking into account patient characteristics, culture, and preferences (Levant, 2005). Effective substance abuse treatments are available, but difficult to disseminate into routine clinical settings (Ball et al., 2002;McGovern & Carroll, 2003). Few studies have systematically tracked how EBPs are transferred to the field (McGovern & Carroll, 2003), and community addiction providers' experiences, beliefs, and readiness to adopt EBPs is largely unknown.Current research suggests that community treatment providers' experience with EBPs is limited (Ball et al., 2002), and when there is some exposure to EBPs, certain EBPs (e.g., Motivational Interviewing, Twelve-Step Facilitation) are more accepted than others (e.g., Contingency Management, addiction-specific medications) (McGovern et al., 2004). Lack of basic knowledge and skills required to assimilate EBPs into daily practice is often cited as a barrier to dissemination and implementation (Corrigan et al., 2001). Organizational characteristics and dynamics may also impact clinician adoption of EBPs (Gotham, 2004).These findings are consistent with a survey of a large national sample of licensed psychologists regarding their attitudes and beliefs about the role of treatment manuals in clinical practice (Addis & Krasnow, 2000). Thirty-seven percent of the sample did not have a clear idea of what a treatment manual was, and 47% reported never using a treatment manual. In addition, some NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript participants held negative views toward treatment manuals, expressing concerns regarding the constraints treatment manuals place on client-therapist relationships and actual impact on improved treatment outcomes. In order to disseminate EBPs effectively, it is useful to identify which treatments clinicians are likely to accept, and the attit...

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Cocaine abusers who fail to manage anger appropriately may have greater difficulty achieving and maintaining abstinence. We conducted a pilot study to examine an anger management group treatment in a sample of 59 men and 32 women with a diagnosis of cocaine dependence. Participants attended a 12-week anger management group treatment and background substance abuse treatment. Levels of anger, negative affect, and anger control were measured at baseline, weekly during treatment, and at 3-month posttreatment follow-up. Levels of anger decreased and anger control increased between baseline and the end of treatment. End-of-treatment changes were maintained at follow-up. These findings were not moderated by gender, age, or psychiatric medication use. In the absence of a randomized control group, we cannot make conclusive statements regarding the effectiveness of the anger management group treatment. However, these preliminary findings demonstrate the need for a randomized clinical trial to test the efficacy of the anger management group treatment.