Effect of PTSD Diagnosis and Contingency Management Procedures on Cocaine Use in Dually Cocaine‐ and Opioid‐Dependent Individuals Maintained on LAAM: A Retrospective Analysis

Mancino, Michael J.; McGaugh, Janette; Feldman, Zachary; Poling, James; Oliveto, Alison

doi:10.1111/j.1521-0391.2009.00025.x

Cited by 12 publications

(12 citation statements)

References 50 publications

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“…A very good strategy for controlling substance use prior to uncovering therapies is to use contingency management. One recent study found that CM resulted in reduced cocaine drug use among opioid dependent patients with PTSD compared to a control condition (Mancino et al, 2010). …”

Section: Resultsmentioning

confidence: 99%

Treatment of substance abusing patients with comorbid psychiatric disorders

Kelly

Daley

Douaihy

2012

Addictive Behaviors

221

163

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Objective To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence based process that enhances treatment effectiveness in comorbid patients. Method Articles were extracted from Pubmed using the search terms “dual diagnosis,” “comorbidity” and “co-occurring” and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity. Results Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second-generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions. Conclusions Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological treatments.

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Section: Resultsmentioning

confidence: 99%

Treatment of substance abusing patients with comorbid psychiatric disorders

Kelly

Daley

Douaihy

2012

Addictive Behaviors

221

163

View full text Add to dashboard Cite

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“…However, more severe complex PTSD (Herman, 1992) predicted less in-treatment abstinence among those randomized to CM (no difference at follow-up; Ford et al 2007). Mancino et al (2010) examined whether PTSD moderated cocaine abstinence outcomes in 140 opiate-dependent LAAM-maintained individuals who were randomized to a CM or non-contingent reinforcement condition. Patients were randomized to one of 4 treatments: low-dose LAAM plus voucher-based CM for drug abstinence based on Higgins et al (1994), low-dose LAAM without CM, high-dose LAAM plus CM, or high-dose LAAM without CM.…”

Section: Interventions For Other Sudmentioning

confidence: 99%

Using incentives to reduce substance use and other health risk behaviors among people with serious mental illness

Tidey

2012

Preventive Medicine

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Introduction Serious mental illness (SMI) is associated with high rates of tobacco and other drug dependence, poor treatment compliance, obesity and low levels of physical activity, which have severe medical and psychosocial consequences. Interventions that effectively reduce these health risk behaviors among people with SMI are urgently needed. Methods Published reports from studies evaluating incentive-based treatments for promoting tobacco and other drug abstinence, treatment attendance, medication use and increased physical activity are reviewed. Results Results of this review indicate the efficacy of incentive-based treatments for reducing tobacco and other drug use among people with SMI. Few studies have examined whether incentive-based treatments improve treatment attendance, medication use and physical activity levels in people with SMI; however, initial evidence is positive and indicates that further research in these areas is warranted. Conclusion Given the medical and psychosocial costs of tobacco and other drug use, treatment non-compliance and physical inactivity, and the efficacy of incentive-based treatments for improving these behaviors, such interventions should be further developed and integrated into behavioral health treatment programs for people with SMI.

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“…Comorbid PTSD and cocaine use disorders are associated with more severe substance use, higher rates of depression, greater interpersonal problems, and worse treatment outcomes than cocaine use problems only (Back et al 2000; Clark et al 2001; Hien et al 2000; Najavits et al 2003). In samples of treatment-seeking cocaine users, patients with PTSD were more likely to relapse during treatment, had shorter periods of abstinence, and were also less treatment-adherent than those without PTSD (Burns et al 2010; Hien et al 2000; Mancino 2010 et al ; Najavits et al 2007). …”

mentioning

confidence: 99%

The Prevalence of Posttraumatic Stress Disorder Symptoms among Addiction Treatment Patients with Cocaine Use Disorders

Saunders

Lambert-Harris

McGovern

et al. 2015

Journal of Psychoactive Drugs

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Co-occurring cocaine use and posttraumatic stress disorders are prevalent and associated with negative treatment, health and societal consequences. This study examined the relationships among PTSD symptoms, gender, and cocaine use problems. Within a cross-sectional design, we gathered archival point prevalence data on new admissions (n = 573) to three addiction treatment agencies. Demographic, substance use, and PTSD symptom information were collected across the three agencies. Logistic regression analyses revealed that patients with cocaine use disorders had a two-fold increased odds for a probable PTSD diagnosis, compared to patients without a cocaine use disorder (OR = 2.19, 95% CI = 1.49–3.22, p < 0.001). Among females with cocaine use disorder, multinomial regression yielded a significant increase in the risk of moderate (RRR = 2.12, 95% CI = 1.10–4.10, p < 0.05) and severe (RRR = 2.87, 95% CI = 1.33–6.21, p < 0.01) PTSD symptoms. Males with cocaine use disorders had a two-fold increase in the risk of moderate PTSD symptoms (RRR = 2.13, 95% CI = 1.23–3.68, p < 0.01), but had no increased risk of developing severe PTSD symptoms (RRR = 1.93, 95% CI = 0.85–4.39, p = 0.117). Cocaine use appears to impact the risk of PTSD symptoms, especially in females. Future research should explore the generalizability of these findings to more racially and ethnically diverse samples, as well as among persons with this comorbidity who are not engaged in treatment services.

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Effect of PTSD Diagnosis and Contingency Management Procedures on Cocaine Use in Dually Cocaine‐ and Opioid‐Dependent Individuals Maintained on LAAM: A Retrospective Analysis

Cited by 12 publications

References 50 publications

Treatment of substance abusing patients with comorbid psychiatric disorders

Treatment of substance abusing patients with comorbid psychiatric disorders

Using incentives to reduce substance use and other health risk behaviors among people with serious mental illness

The Prevalence of Posttraumatic Stress Disorder Symptoms among Addiction Treatment Patients with Cocaine Use Disorders

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