Combined behavioral and pharmacological treatment of alcoholic methadone patients

Bickel, Warren K.; Rizzuto, Pamela; Zielony, Robert D.; Klobas, Jacqueline; Pangiosonlis, Panorea; Mernit, Ralph; Knight, Williams F.

doi:10.1016/s0899-3289(88)80019-1

Cited by 23 publications

(13 citation statements)

References 12 publications

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“…To date, there have been few large-scale studies examining combination treatments for OUD and AUD. Early work with patients with AUD and OUD on methadone maintenance found that making receipt of methadone contingent on taking disulfiram was an effective method for reducing alcohol consumption and increasing engagement with treatment (Bickel et al, 1988), however adding disulfiram to methadone maintenance without contingencies was not more effective than placebo (Ling et al, 1983). One of the more promising medications for treating both OUD and AUD is extended release naltrexone, which has been approved for both indications by the FDA and has shown positive results for treating patients with either OUD or AUD (Gastfriend, 2011; Hartung et al, 2014).…”

Section: Treatment Of Comorbid Oud and Audmentioning

confidence: 99%

Alcohol and Opioid Use, Co‐Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review

Witkiewitz

Vowles

2018

Alcoholism Clin & Exp Res

182

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The dramatic increase in opioid misuse, opioid use disorder (OUD), and opioid-related overdose deaths in the United States has led to public outcry, policy statements, and funding initiatives. Meanwhile, alcohol misuse and alcohol use disorder (AUD) are a highly prevalent public health problem associated with considerable individual and societal costs. This study provides a critical review of alcohol and opioid misuse, including issues of prevalence, morbidity, and societal costs. We also review research on interactions between alcohol and opioid use, the influence of opioids and alcohol on AUD and OUD treatment outcomes, respectively, the role of pain in the co-use of alcohol and opioids, and treatment of comorbid OUD and AUD. Heavy drinking, opioid misuse, and chronic pain individually represent significant public health problems. Few studies have examined co-use of alcohol and opioids, but available data suggest that co-use is common and likely contributes to opioid overdose-related morbidity and mortality. Co-use of opioids and alcohol is related to worse outcomes in treatment for either substance. Finally, chronic pain frequently co-occurs with use (and co-use) of alcohol and opioids. Opioid use and alcohol use are also likely to complicate the treatment of chronic pain. Research on the interactions between alcohol and opioids, as well as treatment of the comorbid disorders is lacking. Currently, most alcohol research excludes patients with OUD and there is lack of measurement in both AUD and OUD research in relation to pain-related functioning. Research in those with chronic pain often assesses opioid use, but rarely assesses alcohol use or AUD. New research to examine the nexus of alcohol, opioids, and pain, as well as their treatment, is critically needed.

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Section: Treatment Of Comorbid Oud and Audmentioning

confidence: 99%

Alcohol and Opioid Use, Co‐Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review

Witkiewitz

Vowles

2018

Alcoholism Clin & Exp Res

182

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“…CM improves substance use treatment outcomes across a wide range of treatment settings and populations (Davis et al, 2016; Dutra et al, 2008; Lussier et al, 2006; Prendergast et al, 2006), but few studies have examined effects of CM on reducing drinking due to the alcohol measurement issues discussed above. Thus, research has relied predominately on reinforcing infrequent negative breath tests in the clinic (Bickel et al, 1988; Hagedorn et al, 2013; Helmus et al, 2003; Litt et al, 2007; Miller, 1975; Petry et al, 2000), more frequent negative breath tests in the natural environment (Alessi and Petry, 2013), or clinic urine tests negative for ethyl glucuronide, an alcohol metabolite with about a 2-day detection window (McDonell et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Experiences with SCRAMx alcohol monitoring technology in 100 alcohol treatment outpatients

Alessi

Barnett

Petry

2017

Drug and Alcohol Dependence

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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. Study 1 participants were randomized to usual care (n=36) or usual care with contingency management incentives for treatment attendance (CM-Att; n=30). Study 2 participants were randomized to usual care (n=17) or usual care with CM for each day of no drinking per SCRAMx (CM-Abst; n=17). After 12 weeks, participants completed a survey about the bracelet. Results Nine percent of individuals screened (54 of 595) declined participation because of the bracelet. Of participants, 84% provided 12 weeks of data, and 96% of bracelets were returned fully intact. Ninety-four equipment tampers occurred, affecting 2% of monitoring days; 56% (67) of tampers coincided with detected drinking. Common concerns reported by participants were skin marks (58%), irritation (54%), and interfered with clothing choices (51%), but severity ratings were generally mild (60%-94%). Eighty-one percent of participants reported that the bracelet helped them reduce drinking, and 75% indicated that they would wear it for longer. A common suggestion for improvement was to reduce the size of the bracelet. Conclusions Results support the viability of transdermal monitoring in voluntary substance abuse treatment participants for an extended duration. Issues to consider for future applications of this technology are discussed.

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“…Fortunately, treatment of alcohol dependence, although not curative, has shown to be effective (O'Malley et al, 1992;Volpicelli, Alteerman, Hayashida, & O'Brien, 1992). As well, preliminary studies have shown that the treatment of alcohol dependence in methadone-using patients can be effective (Bickel et al, 1989). Therefore, awareness of the potential influence of MMT on alcohol consumption is important, as early recognition and treatment of alcohol dependence in patients could have a major impact on treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

The effect of methadone maintenance treatment on alcohol consumption: A systematic review

Srivastava

Kahan

Ross

2008

Journal of Substance Abuse Treatment

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Combined behavioral and pharmacological treatment of alcoholic methadone patients

Cited by 23 publications

References 12 publications

Alcohol and Opioid Use, Co‐Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review

Alcohol and Opioid Use, Co‐Use, and Chronic Pain in the Context of the Opioid Epidemic: A Critical Review

Experiences with SCRAMx alcohol monitoring technology in 100 alcohol treatment outpatients

The effect of methadone maintenance treatment on alcohol consumption: A systematic review

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