A stepped care approach for reducing cannabis use in opioid-dependent outpatients

Kidorf, Michael; Neufeld, Karin J.; King, Van L.; Clark, Michael R.; Brooner, Robert K.

doi:10.1016/j.jsat.2006.09.005

Cited by 17 publications

(14 citation statements)

References 30 publications

(50 reference statements)

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“…In this context, it is not surprising to observe high rates for use of substances other than opiates among MMT patients, and addictive behaviors persisting after treatment initiation (Clarke et al, 2001;Moitra et al, 2013;Richter et al, 2001;SAMHSA, 2012;White et al, 2014). While not appearing to be significant factors of MMT discontinuation, these behaviors may suggest that many patients spend a considerable proportion of recovery time taking other substances and are likely to be exposed to many of the health risks inherent in chronic substance use (Kidorf et al, 2007). Consequently, cannabis use in methadone patients should be monitored more for its own inherent effects on health (dependence syndrome, impaired respiratory function, cardiovascular disease) (Hall, 2015) than for its presumed causal relationship with treatment dropout or heroin or cocaine use (Epstein & Preston, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Patients who initiate MMT are likely to concurrently use psychoactive substances other than opiates (Clarke, Stein, McGarry, & Gogineni, 2001;Moitra, Anderson, & Stein, 2013;Richter, Gibson, Ahluwalia, & Schmelzle, 2001;White et al, 2014), in particular cannabis, which is also the most-used illicit substance in industrialized countries (Compton, Thomas, Conway, & Colliver, 2005;Kidorf, Neufeld, King, Clark, & Brooner, 2007). Research results are mixed regarding the effect of MMT on cannabis use, and measurements of the drug's use during treatment are infrequently and irregularly reported in the literature (Amato et al, 2005;SAMHSA, 2012).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Variations in Cannabis Use Level and Correlates in Opiate-Users on Methadone Maintenance Treatment: A French Prospective Study

Mayet

Lions

Roux

et al. 2015

Journal of Substance Abuse Treatment

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Variations in Cannabis Use Level and Correlates in Opiate-Users on Methadone Maintenance Treatment: A French Prospective Study

Mayet

Lions

Roux

et al. 2015

Journal of Substance Abuse Treatment

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“…Indeed, while one small study has used a CM approach to sequentially target cocaine use and then cannabis use (Budney, Higgins, Delaney, Kent, & Bickel, 1991), and two other small studies have tested approaches to reducing cannabis use among methadone maintenance patients (Calsyn & Saxon, 1999;Kidorf, Neufeld, King, Clark, & Brooner, 2007), only two psychosocial interventions to date have been developed to explicitly and concurrently target cannabis use disorders and other substance use or psychiatric disorders (Edwards et al, 2006;Hoch et al, 2012).…”

Section: Psychosocial Treatmentmentioning

confidence: 99%

“…With respect to cannabis use disorders, two studies have explicitly endorsed a SCA for reducing cannabis use in comorbid populations (Baker, Turner, Kay-Lambkin, & Lewin, 2009;Kidorf et al, 2007), and other research has evaluated brief interventions and "check-up" approaches that target users who are ambivalent about change (Fischer et al, 2013;Stephens et al, 2004). It is noteworthy that only two psychosocial interventions to date have been explicitly developed and evaluated for the targeted treatment of cannabis use disorders and concurrent addictive or psychiatric disorders (Edwards et al, 2006;Hoch et al, 2012), a population of which might represent one of the upper echelons of cannabis problem severity.…”

Section: Stepped Care Approachmentioning

confidence: 99%

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

Stea

Yakovenko

Hodgins

2015

Psychology of Addictive Behaviors

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The recovery process from cannabis use disorders has received little empirical attention. Understanding how and the ways in which individuals with cannabis use disorders recover may help to improve formal treatments and facilitate recovery for those who wish to not seek treatment. The present study was undertaken with two primary objectives in mind. The first primary objective was to provide an exploratory portrait of the recovery process from cannabis use disorders from the perspective of individuals who have recovered. The second primary objective was to explore and systematically describe the similarities and differences between abstinence-and moderation-oriented recoveries, as well as the similarities and differences between treatment-assisted and natural recoveries. The methodology was largely borrowed from the natural recovery literature insofar as recovery was first inferred via the remission of diagnostic symptoms, and then explored predominantly via several interview domains (e.g., reasons for resolution, actions taken to recover, maintenance factors, barriers to treatment seeking).Several interesting and important findings emerged at the level of the total sample (N = 119), as well as at the level of group comparisons between the different recovery pathways. Notably, the findings lend further support to the effectiveness of cognitive, motivational, and behavioural strategies as helpful actions and maintenance factors

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“…Adaptive interventions have been shown to be effective in treating a wide range of substance abuse disorders, including tobacco dependence (Reid, Pipe, Higginson, Johnson, D'Angelo, Cooke et al, 2003), opiate dependence (Brooner, Kidorf, King, Stoller, Peirce, Bigelow & Kolodner, 2004;Brooner, Kidorf, Stoller, Neufeld & Kolodner, 2007;Kidorf, Neufeld & Brooner, 2004;King, Stoller, Hayes, Umbricht, Currens, Kidorf et al, 2002), cannabis abuse (Kidorf, Neufeld, King, Clark & Brooner, 2007), alcoholism (O'Malley, Rounsaville, Farren, Namkoong, Wu, Robinson et al, 2003) and continuing-care interventions for drug dependence (McKay, Lynch, Shepard, Morgenstern, Forman & Pettinatti, 2005, McKay, Lynch, Shepard & Pettinatti, 2005. The specific content and structure of the adaptive interventions vary depending upon the nature of the disorder being treated; however, the findings from these studies suggest that employing standardized criteria for determining when and how to respond to clients' progress or lack thereof in treatment can yield significant improvements beyond that obtained when professionals exercise individualized judgment in specific cases.…”

mentioning

confidence: 99%

Adaptive Interventions in Drug Court

Marlowe

Festinger

Arabia

et al. 2008

Criminal Justice Review

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This pilot study (N = 30) experimentally examined the effects of an adaptive intervention in an adult misdemeanor drug court. The adaptive algorithm adjusted the frequency of judicial status hearings and clinical case-management sessions according to pre-specified criteria in response to participants' ongoing performance in the program. Results revealed the adaptive algorithm was acceptable to both clients and staff, feasible to implement with greater than 85% fidelity, and showed promise for eliciting clinically meaningful improvements in drug abstinence and graduation rates. Estimated effect sizes ranged from 0.40 to 0.60 across various dependent measures. Compared to drug court as-usual, participants in the adaptive condition were more likely to receive responses from the drug court team for inadequate performance in the program and received those responses after a substantially shorter period of time. This suggests the adaptive algorithm may have more readily focused the drug court team's attention on poorly-performing individuals, thus allowing the team to "nip problems in the bud" before they developed too fully. These preliminary data justify additional research evaluating the effects of the adaptive algorithm in a fully powered experimental trial.Adaptive interventions adjust the dose or type of services that are administered to clients in response to clients' clinical presentation or on-going performance in treatment (e.g., Collins, Murphy & Bierman, 2004;Murphy, 2005;Murphy, Lynch, McKay, Oslin & TenHave, 2007). Matching services to clients' pre-treatment characteristics is perhaps the simplest form of adapting treatment to the needs of the individual. For example, tailoring services to the needs of youths or racial minorities is one common approach to adapting treatment for the individual. Similarly, a history of negative outcomes in prior treatment episodes might lead a program to offer a higher dosage or greater variety of services for a new client than would ordinarily be provided to new admissions. This, too, is a simple form of adapting treatment to the needs of the individual.At a more sophisticated level of adaptive programming, the nature or intensity of services is readjusted over time according to pre-specified criteria as a consequence of clients' performance in treatment. For example, if a client falls below an effective threshold for engagement in treatment-by, for example, missing a pre-specified number of counseling sessions-he or she might be re-assigned to a motivational enhancement intervention. The term matching is commonly used to describe strategies that tailor treatment to clients' baseline characteristics whereas the term adaptive is commonly used for strategies that re-adjust the Address correspondence to Douglas B. Marlowe, J.D., Ph.D., Treatment Research Institute, 600 Public Ledger Bldg., 150 South Independence Mall West, Philadelphia, PA 19106. (215) 399-0980. (215) 399-0987 (fax). dmarlowe@tresearch.org.. NIH Public Access Author ManuscriptCrim Justice Rev. Aut...

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A stepped care approach for reducing cannabis use in opioid-dependent outpatients

Cited by 17 publications

References 30 publications

Variations in Cannabis Use Level and Correlates in Opiate-Users on Methadone Maintenance Treatment: A French Prospective Study

Variations in Cannabis Use Level and Correlates in Opiate-Users on Methadone Maintenance Treatment: A French Prospective Study

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

Adaptive Interventions in Drug Court

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