Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users

Klimas, Jan; Fairgrieve, Christopher; Tobin, Helen; Field, Catherine Anne; O’Gorman, Clodagh S.; Glynn, Liam; Keenan, Eamon; Saunders, Jean; Bury, Gerard; Dunne, Colum P.; Cullen, William R.

doi:10.1002/14651858.cd009269.pub4

Cited by 43 publications

(30 citation statements)

References 115 publications

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“…Furthermore, when screening does occur in these settings it is often completed without the use of a validated screening tool [7, 58]. Suggested reasons for these findings identify time restrictions, lack of resources and physician attitudes about the effectiveness of screening and brief intervention for the detection and management of alcohol misuse [52]. …”

Section: Screeningmentioning

confidence: 99%

“…Furthermore a pilot study and randomized controlled trial have identified motivational interviewing to be an effective strategy to reduce alcohol consumption among alcohol misusing methadone maintained participants [51, 53]. Though not specific to OAT participants, psychosocial interventions for alcohol misuse among concurrent substance users have been described in a systematic review [52]. Four studies involving 594 participants evaluated 6 psychosocial interventions through 4 comparison groups: cognitive-behavioral coping skills training versus 12-step facilitation (n = 41) [63], brief intervention versus treatment as usual (n = 110) [64], hepatitis health promotion versus motivational interviewing (n = 256) [51] and brief motivational intervention versus assessment only group (n = 187) [65].…”

Section: Managementmentioning

confidence: 99%

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Alcohol use in opioid agonist treatment

Nolan

Klimas

Wood

2016

Addict Sci Clin Pract

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Alcohol misuse among individuals receiving agonist treatment for an opioid use disorder is common and is associated with significant morbidity and mortality. At present, though substantial research highlights effective strategies for the screening, diagnosis and management of an alcohol or opioid use disorder individually, less is known about how best to care for those with a dual diagnosis especially since common treatments for opioid addiction may be contraindicated in a setting of alcohol use. This review summarizes existing research and characterizes the prevalence, clinical implications and management of alcohol misuse among individuals with opioid addiction. Furthermore, it highlights clinically relevant management strategies in need of future research to advance care for this unique, but important, patient population.

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Section: Screeningmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Alcohol use in opioid agonist treatment

Nolan

Klimas

Wood

2016

Addict Sci Clin Pract

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“…However, intervention trials generally target a single substance rather than dual-substance problems, leaving a smaller literature on dual-focused interventions. Literature reviews of existing studies show promise for such dual-focus interventions (Arias & Kranzler, 2008; Klimas et al, 2014). However, none of these studies included HIV samples, and to our knowledge, no other published trials examined dual drug-and-alcohol-focused interventions in HIV-infected samples.…”

Section: Introductionmentioning

confidence: 99%

HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial

Aharonovich

Stohl

Cannizzaro

et al. 2017

Journal of Substance Abuse Treatment

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Aims Co-occurrence of drug and alcohol use among people living with HIV is linked to poor medication adherence and lack of viral suppression. HealthCall, a technological enhancement of brief Motivational Interviewing (MI), involves brief daily self-monitoring, positive reinforcement, and personalized feedback. This randomized pilot study among people living with HIV investigated the feasibility and efficacy of reducing non-injection drug and alcohol use with MI + HealthCall as adapted for smartphone technology. Design An urban, largely-minority community sample of adults living with HIV were screened for eligibility: last 30 day use of non-injection drugs (≥4 days of crack/cocaine, methamphetamine, or heroin use) and binge drinking (≥1 day of 4+ standard drinks). Those eligible were randomized to one of two groups: MI-only (n = 21) and MI + HealthCall-S (n = 21). Trained counselors delivered the brief MI at baseline. Drug and alcohol use assessments were completed at baseline, 30 and 60 days (end of treatment). Primary outcomes derived from a Timeline Follow Back (TLFB) of the past 30 days included (1) total number of days used primary drug (NumDU) (2) total quantity of primary drug used (dollar amount spent per day; QuantU), (3) total number of drinking days (NumDD) and (4) mean number of drinks per day (QuantDD). Feasibility was determined by HealthCall use rates, patient satisfaction questionnaire (1–5 scale, 5 being best), and retention. Findings The median daily use rate for HealthCall was 95%, patient satisfaction was excellent (4.5) and retention was high (93%). Both treatment groups reduced drug and alcohol use by end of treatment, with MI+Healthcall-S showing significantly greater reductions than MI-only in QuantU (p=0.01) and NumDU (p=0.046). P-values for reductions in alcohol quantity and frequency in the MI+Healthcall group were 0.09–0.11. Conclusions This proof-of-concept randomized trial indicates that HealthCall on the smartphone is a highly feasible intervention in urban, minority individuals with HIV, and suggests efficacy in reducing co-occurring drug and alcohol use. Results suggest opportunities for brief behavioral intervention that may be enhanced through interactive mobile technology to address complex alcohol and drug use patterns that interfere with HIV care, medication adherence and ultimately, viral suppression. A larger randomized trial is warranted to replicate and extend present results.

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“…Hulshof and Hoenen 2007; Joosen et al 2015; Kinnunen-Amoroso 2013). The Cochrane work group has conducted a number of systematic reviews, summarizing the body of knowledge-related occupational health and safety (e.g., Klimas et al 2014; Ruotsalainen et al 2015). In Sweden, the government decided to initiate an investigation into how to secure and develop the competence of the OHS.…”

Section: Introductionmentioning

confidence: 99%

Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators

Brämberg

Nyman

Kwak

et al. 2017

Int Arch Occup Environ Health

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PurposeThe Swedish government initiated an investigation of how to secure and develop the competence of the occupational health services. The primary aim of the present study was to investigate whether the development of evidence-based practice (EBP) in the Swedish occupational health services in relation to attitudes, knowledge and use improved during the first 3 years of the government’s initiative.MethodsThe study has a mixed methods design combining questionnaires and interviews with data collection at baseline and at 3-year follow-up.ResultsThe response rate was 66% at baseline and 63% at follow-up. The results show that practitioners’ knowledge of EBP was moderate at baseline and improved at follow-up (p = 0.002; 95% CI 0.01; 0.21). Practitioners experienced lower levels of organizational and managerial support for EBP at follow-up (p < 0.001; 95% CI 0.18; 0.38). The results revealed that managers viewed responsibility for implementing EBP as a matter for individual practitioners rather than as an organizational issue.ConclusionsOccupational health service managers and practitioners are generally positive to EBP. However, the findings emphasize the need to educate managers in how to support EBP at the organizational level by creating an infrastructure for EBP in the OHS.

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Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users

Abstract: Analysis 1.1. Comparison 1 Cognitive-behavioural coping skills training (CBCST) versus twelve-step facilitation (TSF) programme, Outcome 1 Alcohol abstinence as number achieving 3 or more weeks of consecutive alcohol abstinence during treatment.

Cited by 43 publications

References 115 publications

Alcohol use in opioid agonist treatment

Alcohol use in opioid agonist treatment

HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial

Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators

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