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Web-Based Treatment for Substance Use Disorders: Differential Effects by Primary Substance.

Addictive Behaviors 2015;45:191-194. [doi: 10.1016/j.addbeh.2015.02.002]

Gerald Cochran, PhD (University of Pittsburgh), Maxine L. Stitzer, PhD (Johns Hopkins University School of Medicine, MA Node), Aimee N. C. Campbell, PhD, MSW (New York State Psychiatric Hospital, GNY), Mei-Chen Hu, PhD (Columbia University, GNY Node), Ryan Vandrey, PhD (Johns Hopkins University School of Medicine, MA Node), Edward V. Nunes, MD (Columbia University, GNY Node).

This secondary analysis of data from a large, multi-site effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network (CTN-0044, "Web-Delivery of Evidence-Based, Psychosocial Treatment for Substance Use Disorders"), sought to determine whether effects of a web-based behavioral treatment (Therapeutic Education System (TES)) differed by participants' self-identified primary drug of abuse. The all-comers sample of individuals entering outpatient psychosocial counseling treatment for substance abuse (N=497) cited cannabis (22.9%), stimulants (34.4%), opioids (21.7%), or alcohol (20.9%) as their primary substance of abuse. Participants were randomly assigned to receive treatment-as-usual (TAU) with or without TES substituted for approximately 2 hours of usual counseilng. Multivariate analyses of abstinence outcomes examined interactions of treatment effects with primary substance.

Adjusted odds ratios (AORs) demonstrated that primary stimulant users receiving TES were more likely to be abstinent in the final four weeks of treatment compared to stimulant users receiving TAU. Adjusted odds ratios for alcohol and cannabis were also of similar magnitude to stimulants but did not reach significance. Abstinence among primary opioid users was not improved by the TES intervention.

Conclusions: This study supports the TES web-delivered treatment as a viable intervention for the majority of substance users entering outpatient counseling treatment, with demonstrated effectiveness among stimulant users and promising effects in alcohol and cannabis users, but little or no effect in primary opioid users. Web-delievered treatments hold promise for expanding the availability of effective behavioral interventions for the majority of substance use disorders. (Article (Peer-Reviewed), PDF, English, 2015)

Keywords: Alcohol | Behavior therapy | Cocaine | Community Reinforcement Approach (CRA) | CTN platform/ancillary study | Heroin | Marijuana | Motivational incentives | Prescription-type opiates | Stimulant abuse | Therapeutic Education System (TES) | Addictive Behaviors (journal)

Document No: 1123, PMID: 25697725, PMCID: PMC4373961.

Submitted by CTN Dissemination Librarians, 2/11/2015.

AUTHORS SEARCH LINK
Campbell, Aimee N. C mail
Cochran, Gerald mail
Hu, Mei-Chen
Nunes, Edward V. mail
Stitzer, Maxine L. mail
Vandrey, Ryan
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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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