Mental and Social Health Commons^™

Buprenorphine Physician Supply: Relationship With State-Level Prescription Opioid Mortality, Hannah K. Knudsen, Jennifer R. Havens, Michelle R. Lofwall, Jamie L. Studts, Sharon L. Walsh

Behavioral Science Faculty Publications

Background: Buprenorphine is an effective treatment for opioid use disorder but the supply of buprenorphine physicians is currently inadequate to address the nation’s prescription opioid crisis. Perception of need due to rising opioid overdose rates is one possible reason for physicians to adopt buprenorphine. This study examined associations between rates of growth in buprenorphine physicians and prescription opioid overdose mortality rates in US states.

Methods: The total buprenorphine physician supply and number of physicians approved to treat 100 patients (per 100,000 population) were measured from June 2013 to January 2016. States were divided into two groups: those with rates of …

Tobacco Product Use Among Lesbian, Gay, And Bisexual Adolescents., Hongying Dai

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Sexual minority youth face health disparities and a high risk of substance abuse. This study sought to fully characterize the disparity of tobacco use and risk factors in this high-risk subpopulation.

METHODS: Using data from the 2015 Youth Risk Behavior Survey, the current use of various tobacco products (cigarettes, smokeless tobacco, cigars, and e-cigarettes) was compared according to sex and distinct sexual identities (lesbian, gay, bisexual, and unsure). Heterosexual/straight adolescents served as the control group.

RESULTS: Of 14 703 respondents, 88.8% were heterosexual/straight, 2.0% were lesbian or gay, 6.0% were bisexual, and 3.2% were unsure about their sexual identity. …

Prevention Of Recurrent Affective Episodes Using Extinction Training In The Reconsolidation Window: A Testable Psychotherapeutic Strategy., Robert M Post, Robert Kegan

Psychiatry and Behavioral Sciences Faculty Publications

Stressors may initially precipitate affective episodes, but with sufficient numbers of recurrences, episodes can occur more autonomously. It is postulated the memory engram for these recurrent depressions moves from the conscious representational memory system to the unconscious habit memory system encoded in the striatum. If this were the case, cognitive behavior therapy targeted toward extinction of habit memories could be an effective maneuver for helping reverse the automaticity of affective episode recurrence. Extinction training in the reconsolidation window (which opens about 5 min to 1 h after active memory recall) can revise, reverse, or eliminate the long term memories associated …

Habituation Of Distress And Craving During Treatment As Predictors Of Change In Ptsd Symptoms And Substance Use Severity, Christal L. Badour, Julianne C. Flanagan, Daniel F. Gros, Therese Killeen, Irene Pericot-Valverde, Kristina J. Korte, Nicholas P. Allan, Sudie E. Back

Psychology Faculty Publications

Objective—Increasing evidence supports the efficacy of trauma-focused exposure therapy in the treatment of posttraumatic stress disorder (PTSD) and co-occurring substance use disorders. Little is known, however, about the mechanisms of change in treatment for patients with PTSD and co-occurring substance use disorders. The aim of the present study was to examine whether within- and between-session habituation of distress and substance craving during imaginal exposure relates to treatment outcomes among U.S. military veterans with PTSD and a co-occurring substance use disorder (N = 54).

Method—Veterans received Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure, a manualized …

Faster Self-Paced Rate Of Drinking For Alcohol Mixed With Energy Drinks Versus Alcohol Alone, Cecile A. Marczinski, Mark T. Fillmore, Sarah F. Maloney, Amy L. Stamates

Psychology Faculty Publications

The consumption of alcohol mixed with energy drinks (AmED) has been associated with higher rates of binge drinking and impaired driving when compared with alcohol alone. However, it remains unclear why the risks of use of AmED are heightened compared with alcohol alone even when the doses of alcohol consumed are similar. Therefore, the purpose of this laboratory study was to investigate if the rate of self-paced beverage consumption was faster for a dose of AmED versus alcohol alone using a double-blind, within-subjects, placebo-controlled study design. Participants (n = 16) of equal gender who were social drinkers attended 4 separate …

Oral Cannabidiol Does Not Produce A Signal For Abuse Liability In Frequent Marijuana Smokers, Shanna Babalonis, Margaret Haney, Robert J. Malcolm, Michelle R. Lofwall, Victoria R. Votaw, Steven Sparenborg, Sharon L. Walsh

Behavioral Science Faculty Publications

Background—Cannabidiol (CBD) is a naturally occurring constituent of the marijuana plant. In the past few years, there has been great interest in the therapeutic effects of isolated CBD and it is currently being explored for numerous disease conditions (e.g., pain, epilepsy, cancer, various drug dependencies). However, CBD remains a Schedule I drug on the U.S. Controlled Substances Act (CSA). Despite its status, there are no well-controlled data available regarding its abuse liability.

Methods—Healthy, frequent marijuana users (n=31) were enrolled in this within subject, randomized, placebo-controlled, double-blind, multisite study that administered oral cannabidiol (0, 200, 400, 800 …

The Juvenile Justice Behavioral Health Services Cascade: A New Framework For Measuring Unmet Substance Use Treatment Services Needs Among Adolescent Offenders, Steven Belenko, Danica Knight, Gail A. Wasserman, Michael L. Dennis, Tisha Wiley, Faye S. Taxman, Carrie B. Oser, Richard Dembo, Angela A. Robertson, Jessica Sales

Sociology Faculty Publications

Overview—Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies.

Methods and Results—This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade (“Cascade”), for measuring unmet substance use treatment needs to …

Curbing The Dui Offender's Self-Efficacy To Drink And Drive: A Laboratory Study, Walter Roberts, Mark T. Fillmore

Psychology Faculty Publications

Background—People arrested for driving under the influence of alcohol (DUI) are at high risk to reoffend. One reason for this high rate of recidivism among DUI offenders is that these individuals systematically underestimate the degree to which alcohol impairs their ability to drive. This study compared perceived and objective driving ability following alcohol and performance feedback in drivers with and without a history of DUI.

Method—Adult drivers with (n = 20) and without (n = 20) a history of DUI arrest attended two dose challenge sessions where they received 0.64 g/kg alcohol or placebo, completed a simulated driving …

The Art And Skill Of Delivering Culturally Responsive Trauma-Focused Cognitive Behavioral Therapy In Tanzania And Kenya., Briana Woods-Jaeger, Christine M. Kava, Christopher F. Akiba, Leah Lucid, Shannon Dorsey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in …

A Controlled Comparison Trial Of The Collaborative Assessment And Management Of Suicidality (Cams) In An Inpatient Setting: Outcomes At Discharge And Six-Month Follow-Up, Thomas E Ellis, Katrina A Rufino, Jon G Allen

Staff and Researcher Publications

This controlled comparison trial evaluated a suicide-specific intervention, the Collaborative Assessment and Management of Suicidality (CAMS), in an extended-stay psychiatric inpatient setting. Multiple outcomes were examined for 104 patients, half of whom received individual therapy from therapists trained in CAMS. The comparison group was selected from a larger pool through Propensity Score Matching to ensure comparability on age, sex, treatment program, number of prior suicide attempts, and severity of suicidal ideation. Results showed that a) all patients improved significantly across a wide range of measures, including depression, suicidal ideation, functional disability, and well-being; b) these gains were durable over a …

A Quantitative Lc-Ms/Ms Method For Simultaneous Determination Of Cocaine And Its Metabolites In Whole Blood, Xiabin Chen, Xirong Zheng, Kai Ding, Ziyuan Zhou, Chang-Guo Zhan, Fang Zheng

Molecular Modeling and Biopharmaceutical Center Faculty Publications

As new metabolic pathways of cocaine were recently identified, a high performance liquid chromatography tandem mass spectrometry (LC–MS/MS) method was developed to simultaneously determine cocaine and nine cocaine-related metabolites in whole blood samples. One-step solid phase extraction was used to extract all of the ten compounds and corresponding internal standards from blood samples. All compounds and internal standards extracted were separated on an Atlantis T3 (100 Å, 3 μm, 2.1 mm × 150 mm I.D) column and detected in positive ion and high sensitivity mode with multiple reaction monitoring. This method was validated for its sensitivity, linearity, specificity, accuracy, precision, …

Does Mental Status Impact Therapist And Patient Communication In Emergency Department Brief Interventions Addressing Alcohol Use?, Brian Borsari, Timothy R. Apodaca, Ali Yurasek, Peter M. Monti

Manuscripts, Articles, Book Chapters and Other Papers

Motivational interviewing (MI) is often incorporated into screening, brief intervention, and referral to treatment (SBIRT) interventions in critical care settings to address alcohol and other drug use. However, cognitive status has been linked to differential response to MI sessions in emergency department (ED) settings. The current study examined one possible explanation for this differential response: whether higher versus lower mental status impacts patient response to clinician statements during MI sessions conducted in an ED. Participants were 126 patients receiving an MI-based single-session alcohol brief intervention, and 13 therapists who provided treatment. Participants completed a mental status exam (MSE) as part …

Treatment Outcomes For Inpatients With Obsessive-Compulsive Personality Disorder: An Open Comparison Trial, Ryan Smith, Christopher Shepard, Anika Wiltgen, Katrina Rufino, J Christopher Fowler

Staff and Researcher Publications

Background: The current case-control study compared rates of clinically significant and reliable change in psychopathology and global functioning, prevalence of clinical deterioration, and rates of symptom remission among adult patients with obsessive compulsive personality disorder OCPD (n=52) and well-matched inpatients with any other personality disorder (n=56) and no personality disorder (n=53).

Methods: Propensity score matching (PSM) was utilized to select patients matched on specific criteria present in the OCPD group. Multivariate analysis of variance models measured differences in admission functioning and RCI change across depression and anxiety severity, emotion dysregulation and suicidal ideation.

Results: Patients diagnosed with OCPD admit to …

Mental Health Treatment Seeking Patterns And Preferences Of Appalachian Women With Depression, Claire Snell-Rood, Emily Hauenstein, Carl G. Leukefeld, Frances Feltner, Amber Marcum, Nancy E. Schoenberg

Behavioral Science Faculty Publications

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia—a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants’ perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. …

Developmental Toxicity Of Nicotine: A Transdisciplinary Synthesis And Implications For Emerging Tobacco Products, Lucinda J. Enland, Kjersti Aagaard, Michele Bloch, Kevin Conway, Kelly Cosgrove, Rachel Grana, Thomas J. Gould, Dorothy Hatsukami, Frances Jensen, Denise Kandel, Bruce Lanphear, Frances Leslie, James R. Pauly, Jenae Neiderhiser, Mark Rubinstein, Theodore A. Slotkin, Eliot Spindel, Laura Stroud, Lauren Wakschlag

Pharmaceutical Sciences Faculty Publications

While the health risks associated with adult cigarette smoking have been well described, effects of nicotine exposure during periods of developmental vulnerability are often overlooked. Using MEDLINE and PubMed literature searches, books, reports and expert opinion, a transdisciplinary group of scientists reviewed human and animal research on the health effects of exposure to nicotine during pregnancy and adolescence. A synthesis of this research supports that nicotine contributes critically to adverse effects of gestational tobacco exposure, including reduced pulmonary function, auditory processing defects, impaired infant cardiorespiratory function, and may contribute to cognitive and behavioral deficits in later life. Nicotine exposure during …

Cellular And Molecular Mechanisms Underlying Alcohol-Induced Aggressiveness Of Breast Cancer, Yongchao Wang, Mei Xu, Zun-Ji Ke, Jia Luo

Pharmacology and Nutritional Sciences Faculty Publications

Breast cancer is a leading cause of morbidity and mortality in women. Both Epidemiological and experimental studies indicate a positive correlation between alcohol consumption and the risk of breast cancer. While alcohol exposure may promote the carcinogenesis or onset of breast cancer, it may as well enhance the progression and aggressiveness of existing mammary tumors. Recent progress in this line of research suggests that alcohol exposure is associated with invasive breast cancer and promotes the growth and metastasis of mammary tumors. There are multiple potential mechanisms involved in alcohol-stimulated progression and aggressiveness of breast cancer. Alcohol may increase the mobility …

Protective Behavioral Strategies As A Context-Specific Mediator: A Multilevel Examination Of Within- And Between-Person Associations Of Daily Drinking, Abby L. Braitman, Ashley N. Linden-Carmichael, James M. Henson

Psychology Faculty Publications

Research indicates that a drinker’s environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one’s drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different …

A Novel Approach To Identifying A Neuroimaging Biomarker For Patients With Serious Mental Illness, Alok Madan, J Christopher Fowler, Michelle A Patriquin, Ramiro Salas, Philip R Baldwin, Kenia M Velasquez, Humsini Viswanath, David L Molfese, Carla Sharp, Jon G Allen, Susan Hardesty, John M Oldham, B Christopher Frueh

Staff and Researcher Publications

Serious mental illness (SMI) is disabling, and current interventions are ineffective for many. This exploratory study sought to demonstrate the feasibility of applying topological data analysis (TDA) to resting-state functional connectivity data obtained from a heterogeneous sample of 235 adult inpatients to identify a biomarker of treatment response. TDA identified two groups based on connectivity between the prefrontal cortex and striatal regions: patients admitted with greater functional connectivity between these regions evidenced less improvement from admission to discharge than patients with lesser connectivity between them. TDA identified a potential biomarker of an attenuated treatment response among inpatients with SMI. Insofar …

Alcohol Use And Strenuous Physical Activity In College Students: A Longitudinal Test Of 2 Explanatory Models Of Health Behavior, Heather A. Davis, Elizabeth N. Riley, Gregory T. Smith, Richard S. Milich, Jessica L. Burris

Psychology Faculty Publications

Objective: To help clarify the effect of gender on the bidirectional relationship between alcohol use and strenuous physical activity in college students. Participants: Five hundred twenty-four (52% female) college students recruited in August 2008 and 2009 and followed up in April 2009 and April 2011, respectively. Methods: Participants reported their alcohol use and strenuous physical activity on 2 occasions (baseline and follow-up) spaced approximately 1 or 2 years apart. Results: For females, alcohol use quantity at baseline was associated with increased strenuous physical activity at 1- and 2-year follow-ups, and alcohol use frequency at baseline was …

Subjective Report Of Side Effects Of Prescribed And Nonprescribed Psychostimulant Use In Young Adults, Tess E. Smith, Michelle M. Martel, Alan D. Desantis

Psychology Faculty Publications

Background: Side effects of prescribed and nonprescribed psychostimulant use are understudied. Objectives: The study examined side effects of prescribed and nonprescribed psychostimulant use in a college sample with attention to possible gender differences. Methods: 2716 undergraduates (1448 male) between the ages of 17 and 57 years (M = 19.43 years, SD = 1.7 years) completed an online survey that included questions about the subjective side effects of prescribed and nonprescribed psychostimulant use. Results: Results suggested that prescribed users more frequently reported side effects, compared to nonprescribed users. For prescribed users, females more frequently reported appetite, somatic, and anxiety-related side …

Accuracy Of Name And Age Data Provided About Network Members In A Social Network Study Of People Who Use Drugs: Implications For Constructing Sociometric Networks, April M. Young, Abby E. Rudolph, Amanda E. Su, Lee King, Susan Jent, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Purpose—Network analysis has become increasingly popular in epidemiologic research, but the accuracy of data key to constructing risk networks is largely unknown. Using network data from people who use drugs (PWUD), the study examined how accurately PWUD reported their network members’ (i.e., alters’) names and ages.

Methods—Data were collected from 2008 to 2010 from 503 PWUD residing in rural Appalachia. Network ties (n=897) involved recent (past 6 months) sex, drug co-usage, and/or social support. Participants provided alters’ names, ages, and relationship-level characteristics; these data were cross-referenced to that of other participants to identify participant-participant relationships and to determine …

The Alcohol Intervention Mechanisms Scale (Aims): Preliminary Reliability And Validity Of A Common Factor Observational Rating Measure., M Magill, Timothy R. Apodaca, Justin Walthers, Jacques Gaume, Ayla Durst, Richard Longabaugh, Robert L. Stout, Kathleen M. Carroll

Manuscripts, Articles, Book Chapters and Other Papers

The present work provides an overview, and pilot reliability and validity for the Alcohol Intervention Mechanisms Scale (AIMS). The AIMS measures therapist interventions that occur broadly across modalities of behavioral treatment for alcohol use disorder. It was developed based on identified commonalities in the function rather than content of therapist interventions in observed therapy sessions, as well as from existing observer rating systems. In the AIMS, the primary function areas are: explore (four behavior count codes), teach (five behavior count codes), and connect (three behavior count codes). Therapist behavior counts provide a frequency rating of occurrence (i.e., adherence). The three …

Plant Expression Of Cocaine Hydrolase-Fc Fusion Protein For Treatment Of Cocaine Abuse, Guojun Wang, Ting Zhang, Haifeng Huang, Shurong Hou, Xiabin Chen, Fang Zheng, Chang-Guo Zhan

Molecular Modeling and Biopharmaceutical Center Faculty Publications

BACKGROUND: A recently reported cocaine hydrolase (CocH3) fused with fragment crystallizable (Fc) region of human immunoglobulin G1, denoted as CocH3-Fc, is known as a promising therapeutic candidate for the treatment of cocaine overdose and addiction. A challenge for practical therapeutic use of this enzyme exists in the large-scale protein production and, therefore, it is interesting to identify a low-cost and feasible, sustainable source of CocH3-Fc production.

RESULTS: CocH3-Fc was transiently expressed in plant Nicotiana benthamiana leaves. The plant-expressed protein, denoted as pCocH3-Fc, was as active as that expressed in mammalian cells both in vitro and in vivo. However, compared to …

Can Academic Medicine Lead The Way In The Refugee Crisis?, Amir A Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

The world is currently in the midst of the largest refugee crisis since World War II, with the highest interval of mass displacement in recorded history according to the United Nations. The United States has pledged to maintain its position as one of the world's top resettlement countries in response to this crisis. These new immigrants will arrive with exceptional chronic and acute medical needs, including higher rates of behavioral health disorders. The author describes the health care challenges experienced by refugees seeking asylum in the United States and outlines the ways in which our health care system is currently …

New Measures To Capture End Of Life Concerns In Huntington Disease: Meaning And Purpose And Concern With Death And Dying From Hdqlife (A Patient-Reported Outcomes Measurement System)., N E Carlozzi, N R Downing, M K Mccormack, S G Schilling, J S Perlmutter, E A Hahn, J S Lai, S Frank, K A Quaid, J S Paulsen, D Cella, S M Goodnight, J A Miner, M A Nance

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is an incurable terminal disease. Thus, end of life (EOL) concerns are common in these individuals. A quantitative measure of EOL concerns in HD would enable a better understanding of how these concerns impact health-related quality of life. Therefore, we developed new measures of EOL for use in HD.

METHODS: An EOL item pool of 45 items was field tested in 507 individuals with prodromal or manifest HD. Exploratory and confirmatory factor analyses (EFA and CFA, respectively) were conducted to establish unidimensional item pools. Item response theory (IRT) and differential item functioning analyses were applied to …

Hdqlife: Development And Assessment Of Health-Related Quality Of Life In Huntington Disease (Hd), N E Carlozzi, S G Schilling, J-S Lai, J S Paulsen, E A Hahn, J S Perlmutter, C A Ross, N R Downing, A L Kratz, M K Mccormack, M A Nance, K A Quaid, J C Stout, R C Gershon, R E Ready, J A Miner, S K Barton, S L Perlman, S M Rao, S Frank, I Shoulson, H Marin, M D Geschwind, P Dayalu, S M Goodnight, D Cella

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is a chronic, debilitating genetic disease that affects physical, emotional, cognitive, and social health. Existing patient-reported outcomes (PROs) of health-related quality of life (HRQOL) used in HD are neither comprehensive, nor do they adequately account for clinically meaningful changes in function. While new PROs examining HRQOL (i.e., Neuro-QoL-Quality of Life in Neurological Disorders and PROMIS-Patient-Reported Outcomes Measurement Information System) offer solutions to many of these shortcomings, they do not include HD-specific content, nor have they been validated in HD. HDQLIFE addresses this by validating 12 PROMIS/Neuro-QoL domains in individuals with HD and by using established PROMIS …

Putting Parity Into Practice – Integrating Opioid-Use Disorder Treatment Into The Hospital Setting, Laura Fanucchi, Michelle R. Lofwall

Center for Health Services Research Faculty Publications

No abstract provided.

African American Female Offender's Use Of Alternative And Traditional Health Services After Re-Entry: Examining The Behavioral Model For Vulnerable Populations, Carrie B. Oser, Amanda M. Bunting, Erin L. Pullen, Danelle Stevens-Watkins

Sociology Faculty Publications

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women's use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number …

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Examining Multi-Session Brief Intervention For Substance Use In Primary Care: Research Methods Of A Randomized Controlled Trial., Jaclyn E Chambers, Adam C Brooks, Rachel Medvin, David S Metzger, Jennifer Lauby, Carolyn M Carpenedo, Kevin E Favor, Kimberly C Kirby

College of Science & Mathematics Departmental Research

BACKGROUND: Brief interventions such as Screening, a single session of Brief Intervention, and Referral to Treatment (SBIRT) have shown mixed effectiveness in primary care. However, there are indications that multi-session brief interventions may demonstrate more consistently positive outcomes, and perhaps a more intensive approach would be of benefit in addressing substance use in primary care. This study compared the effectiveness of SBIRT with a single BI session (BI/RT) to a multi-session brief-treatment intervention (BI/RT+) in primary care. We also developed easy-to-use, evidence-based materials to assist clinicians in delivering these interventions.

METHODS/DESIGN: This study was conducted in three Federally Qualified Healthcare …