Journal of Substance Abuse Treatment RSS feed: Current Issue. The Journal of Substance Abuse Treatment (JSAT) features original research, systematic reviews and reports on meta-analyses and, with editorial approval, special articles on the assessment and treatment of substance use and addictive disorders, including alcohol, illicit and prescription drugs, and nicotine. JSAT values high quality empirical research that is relevant for translation by treatment practitioners from all disciplines and across any setting where persons with substance use problems are encountered. The editors emphasize that JSAT articles should address assessment techniques and treatment approaches that have clear relevance for routine practice. Accordingly, the scope of JSAT includes health services research, including the design, organization, delivery mechanisms and workforce characteristics of treatments in routine settings. It is the policy of JSAT that treatment research for individuals with substance use disorders meet the same scientific evaluative standards as treatments for those with any other health-related condition or illness. Thus, research articles submitted for publication in JSAT are expected to achieve the same empirical standards of reliability, validity, and empiricism. Theoretical models, clinical experience, and case vignettes are recognized as important supplements to, but not as substitutes for, research-based evidence. It is recognized that research-based evidence may take many forms, such as randomized controlled trials; case-controlled field evaluations; or time series evaluations. In early stages of research development, qualitative study or small trials may be appropriate and necessary first steps. Regardless of the specific type of study, authors of research articles should aim to: (1) use one or more reasonable comparison or control conditions in the design and analysis of collected data, (2) use data collection methods and measures that have been previously validated in the subject population, and (3) analyze data (qualitative or quantitative) with the use of appropriate statistical methods. Authors must insure that the research as reported was conducted ethically, and that all protections to human subject participants were afforded. This insurance must be verified by the appropriate institutional review board or committee for the protection of human subjects. In addition, the editors of JSAT will not consider articles that use pejorative and stereotypical expressions when discussing individuals who suffer from substance use disorders. In drawing conclusions, authors are expected to use a parsimonious, cautious and conservative approach in the interpretation of findings. Hyperbole and overgeneralization beyond the data are considered irresponsible. http://www.journalofsubstanceabusetreatment.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Journal of Substance Abuse Treatment0740-5472424June 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.journalofsubstanceabusetreatment.com/article/PIIS0740547212000578/abstract?rss=yesEditorial Board10.1016/S0740-5472(12)00057-8Journal of Substance Abuse Treatment 42, 4 (2012)2012-06-01Journal of Substance Abuse Treatment2012-06-01424S0740-5472(11)X0011-9IFCIFChttp://www.journalofsubstanceabusetreatment.com/article/PIIS0740547212000608/abstract?rss=yesContents10.1016/S0740-5472(12)00060-8Journal of Substance Abuse Treatment 42, 4 (2012)2012-06-01Journal of Substance Abuse Treatment2012-06-01424S0740-5472(11)X0011-9iiiiiihttp://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001826/abstract?rss=yesAbstract: We examined on-site and off-site referral-based provision of substance abuse (SA) treatment services among a sample of community health centers (CHCs). Analyses used survey data collected from CHCs in three states merged with administrative claims to both characterize CHC care delivery models and examine the association between models and care quality. Care quality was based on the Washington Circle measures of initiation and engagement. Approximately half the sample provided at least some SA treatment services on site. The provision of intensive outpatient treatment services on site was associated with significantly higher engagement rates. It was also associated with higher (but not significantly) initiation rates. At the same time, on-site provision of screening and counseling services was negatively associated with both initiation and engagement rates. Given limited resources, investing in more intensive services on site may yield better outcomes for CHC patients than lower level services, but further study is recommended.On-site provision of substance abuse treatment services at community health centersDeborah Gurewich, Jenna T. Sirkin, Donald S. Shepard10.1016/j.jsat.2011.09.012Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-24Journal of Substance Abuse Treatment2011-11-24424S0740-5472(11)X0011-9Regular Articles339345http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001759/abstract?rss=yesAbstract: This study examined client and program factors predicting initiation and engagement for 2,191 adolescents at 28 outpatient substance abuse treatment sites implementing evidence-based treatments. Using Washington Circle criteria for treatment initiation and engagement, 76% of the sample initiated, with 59% engaging in treatment. Analyses used a 2-stage Heckman probit regression, accounting for within-site clustering, to identify factors predictive of initiation and engagement. Adolescents treated in a pay-for-performance (P4P) group were more likely to initiate, whereas adolescents in the race/ethnicity category labeled other (Native American, Asian, Pacific Islander, Native Alaskan, Native Hawaiian, mixed race/ethnicity), or who reported high truancy, were less likely to initiate. Race/ethnicity groups other than Latinos were equally likely to engage. Among White adolescents, each additional day from first treatment to next treatment reduced likelihood of engagement. Although relatively high initiation and engagement rates were achieved, the results suggest that attention to program and client factors may further improve compliance with these performance indicators.Adolescent treatment initiation and engagement in an evidence-based practice initiativeMargaret T. Lee, Deborah W. Garnick, Peggy L. O'Brien, Lee Panas, Grant A. Ritter, Andrea Acevedo, Bryan R. Garner, Rodney R. Funk, Mark D. Godley10.1016/j.jsat.2011.09.005Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-02Journal of Substance Abuse Treatment2011-11-02424S0740-5472(11)X0011-9Regular Articles346355http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001747/abstract?rss=yesAbstract: This study empirically examined opinions of treatment providers regarding contingency management (CM) programs while controlling for experience with a specific efficacious CM program. In addition to empirically describing provider opinions, we examined whether the opinions of providers at the sites that implemented the CM program were more positive than those of matched providers at sites that did not implement it. Participants from 7 CM treatment sites (n = 76) and 7 matched nonparticipating sites (n = 69) within the same nodes of the National Institute of Drug Abuse Clinical Trials Network completed the Provider Survey of Incentives (PSI), which assesses positive and negative beliefs about incentive programs. An intent-to-treat analysis found no differences in the PSI summary scores of providers in CM program versus matched sites, but correcting for experience with tangible incentives showed significant differences, with providers from CM sites reporting more positive opinions than those from matched sites. Some differences were found in opinions regarding costs of incentives, and these generally indicated that participants from CM sites were more likely to see the costs as worthwhile. The results from the study suggest that exposing community treatment providers to incentive programs may itself be an effective strategy in prompting the dissemination of CM interventions.Is exposure to an effective contingency management intervention associated with more positive provider beliefs?Kimberly C. Kirby, Carolyn M. Carpenedo, Maxine L. Stitzer, Karen L. Dugosh, Nancy M. Petry, John M. Roll, Michael E. Saladin, Allan J. Cohen, John Hamilton, Karen Reese, Gina R. Sillo, Patricia Quinn Stabile, Robert C. Sterling10.1016/j.jsat.2011.09.004Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-24Journal of Substance Abuse Treatment2011-11-24424S0740-5472(11)X0011-9Regular Articles356365http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001802/abstract?rss=yesAbstract: Our recent 8-week, randomized, placebo-controlled trial of fluoxetine in adolescents (ages 12-17 years) with comorbid depression and substance use disorder (SUD) did not detect a significant antidepressant treatment effect. The purpose of this secondary analysis was to explore moderators of the effect of fluoxetine in this sample. Static moderators measured at baseline were depression chronicity and hopelessness severity; time-varying moderators measured at baseline and weekly during the 8-week trial period were alcohol and marijuana use severity. Treatment effects on depression outcomes were examined among moderating subgroups in random effects regression models. Subjects assigned to fluoxetine treatment with chronic depression at baseline (p = .04) or no more than moderate alcohol use during the trial (p = .04) showed significantly greater decline in depression symptoms in comparison to placebo-assigned subgroups. The current analysis suggests that youth with chronic depression and no more than moderate alcohol consumption are likely to respond better to treatment with fluoxetine compared with placebo than youth with transient depression and heavy alcohol use.Moderators of fluoxetine treatment response for children and adolescents with comorbid depression and substance use disordersMatthew E. Hirschtritt, Maria E. Pagano, Kelly M. Christian, Nora K. McNamara, Robert J. Stansbrey, Jacqui Lingler, Jon E. Faber, Christine A. Demeter, Denise Bedoya, Robert L. Findling10.1016/j.jsat.2011.09.010Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-24Journal of Substance Abuse Treatment2011-11-24424S0740-5472(11)X0011-9Regular Articles366372http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001784/abstract?rss=yesAbstract: Amphetamine use and abuse carry with it substantial social costs. Although there is a perception that amphetamine users are more difficult to treat than other substance users, drug courts have been used to effectively address drug-related crimes and hold the potential to lessen the impact of amphetamine abuse through efficacious treatment and rehabilitation. The objective of this study was to identify predictors of drug court outcome among amphetamine-using participants. A drug court database was obtained (N = 540) and amphetamine-using participants (n = 341) identified. Multivariate binary regression models run for the amphetamine-using participants identified being employed and being a parent as predictive of successful completion of the program, whereas being sanctioned to jail during the program was inversely related to program completion.Predicting drug court outcome among amphetamine-using participantsLora J. Wu, Sandra J. Altshuler, Robert A. Short, John M. Roll10.1016/j.jsat.2011.09.008Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-28Journal of Substance Abuse Treatment2011-11-28424S0740-5472(11)X0011-9Regular Articles373382http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001796/abstract?rss=yesAbstract: Objectives: This study tested specific intervention responsivity to brief intervention in driving while impaired by alcohol and/or drugs recidivists based upon their demographic, substance use, and initial readiness to change characteristics.Methods: A nonclinical community-based sample of 184 male and female recidivists was randomly assigned to receive one of two 30-minute interventions: brief motivational interviewing (n = 92) or an information–advice session (n = 92). Dependent variables were change at the 6- and 12-month follow-ups from baseline in percentage of risky drinking days and blood assay biomarkers of alcohol misuse. Independent variables were age, gender, education, past convictions for impaired driving, and baseline alcohol and drug misuse severity and readiness to change.Results: Recidivists who were younger, male, and exhibited more negative consequences and ambivalence towards their problem drinking improved more on alcohol-related outcomes, irrespective of intervention type.Conclusions: The results do not convincingly indicate specific intervention responsivity based upon participant characteristics but provide preliminary guidance about which recidivists are most apt to benefit from these brief approaches.The role of demographic characteristics and readiness to change in 12-month outcome from two distinct brief interventions for impaired driversThomas G. Brown, Maurice Dongier, Marie Claude Ouimet, Jacques Tremblay, Florence Chanut, Lucie Legault, N.M.K. Ng Ying Kin10.1016/j.jsat.2011.09.009Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-28Journal of Substance Abuse Treatment2011-11-28424S0740-5472(11)X0011-9Regular Articles383391http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001814/abstract?rss=yesAbstract: This study assessed the correlation between the areas of the interviewer severity rating (ISR) and the areas of the composite scores (CSs) of the European version of the Addiction Severity Index (EuropASI). It evaluated the predictive validity of both types of scoring with regard to completion of treatment. For this purpose, 252 patients were interviewed using the EuropASI; 38.9% of patients discontinued treatment. Results indicated a high correlation between various areas of the ISR and the CS, except the legal and family–others scales. Regarding predictive results, patients with a score greater than 3 in the ISR family area were more likely to quit the program compared with patients with a score lower than 3. Patients with a CS score that was greater than 0.34 in the alcohol use area were more likely to drop out of treatment. When both ISR and CS scores were included in the prediction model, the ISR family area was a better predictor.Predictive validity of the EuropASI: Clinical diagnosis or composite scoring?José J. López-Goñi, Javier Fernández-Montalvo, Alfonso Arteaga10.1016/j.jsat.2011.09.011Journal of Substance Abuse Treatment 42, 4 (2012)2011-10-31Journal of Substance Abuse Treatment2011-10-31424S0740-5472(11)X0011-9Regular Articles392399http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001838/abstract?rss=yesAbstract: Research has not consistently supported an association between stage of change and substance abuse treatment retention. This study examined whether social desirability response bias could help explain why. Participants (N = 200) recruited from an outpatient program completed the University of Rhode Island Change Assessment Scale (URICA), Treatment Readiness Tool (TREAT), Marlowe–Crowne Social Desirability Scale, and other measures. Number of treatment groups attended was collected from program records. In bivariate analyses, neither the URICA nor the TREAT was related to attendance. However, higher social desirability was strongly associated with lower URICA (but not TREAT) total scores, and in a multivariate path model, a moderately strong association emerged between higher URICA scores and greater treatment attendance when accounting for social desirability. Higher social desirability was also an independent predictor of greater treatment attendance and was strongly associated with lower Addiction Severity Index alcohol, drug, and psychiatric severity. Results underline a critical problem in measuring motivation and problem severity that has been largely neglected.The effect of social desirability on reported motivation, substance use severity, and treatment attendanceSarah E. Zemore10.1016/j.jsat.2011.09.013Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-28Journal of Substance Abuse Treatment2011-11-28424S0740-5472(11)X0011-9Regular Articles400412http://www.journalofsubstanceabusetreatment.com/article/PIIS074054721100184X/abstract?rss=yesAbstract: This study assesses relationships between drug administration routes and HIV serostatus, drug use, and sexual behaviors among current injecting drug users (IDUs) in Tallinn, Estonia. We recruited 350 IDUs for a cross-sectional risk behavior survey. Adjusted odds ratios (AORs) were calculated to explore injection risk behavior, sexual behavior, and HIV serostatus associated with multiple route use. Focus groups explored reasons why injectors might use non-injecting routes of administration. Those reporting multiple drug administration routes were less likely to be HIV seropositive (AOR = 0.49, 95% confidence interval [CI] = 0.25–0.97) and had almost twice the odds of having more than one sexual partner (AOR = 1.90, 95% CI = 1.01–3.60) and of reporting having sexually transmitted diseases (AOR = 2.38, 95% CI = 1.02–5.59). IDUs who engage in noninjecting drug use may be reducing their risk of acquiring HIV though sharing injection equipment, but if infected may be a critical group for sexual transmission of HIV to people who do not inject drugs.Multiple routes of drug administration and HIV risk among injecting drug usersSigrid Vorobjov, Anneli Uusküla, Don C. Des Jarlais, Katri Abel-Ollo, Ave Talu, Kristi Rüütel10.1016/j.jsat.2011.09.014Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-24Journal of Substance Abuse Treatment2011-11-24424S0740-5472(11)X0011-9Regular Articles413420http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001851/abstract?rss=yesAbstract: Members of the National Association of Alcoholism and Drug Abuse Counselors (n = 231) participated in a survey concerning their view of the role of personal responsibility in addictions treatment and its relation to their exposure to neuroscience (i.e., the amount to which members considered themselves familiar with current neuroscience research). We used the two-dimensional model of responsibility (Responsible/not responsible for development × Responsible/not responsible for recovery) proposed by P. Brickman et al. (1982) to guide our assessment of responsibility, thus inquiring about counselors' views of clients' responsibility for both the development of a substance-related addiction and its resolution. Findings suggest that counselors rate biological factors as most influential in the development of an addiction and assign clients less personal responsibility for the development of an addiction than for recovery from an addiction. Counselors' level of neuroscience exposure was negatively correlated with their ratings of client responsibility for the development of an addiction but positively correlated to ratings of client responsibility for recovery. This suggests that counselors are integrating neuroscientific findings with what is learned from other modes of enquiry in a way that diminishes the view that clients are responsible for addiction development but accentuates the view that clients are responsible for recovery. We explore reasons for why this is and why this approach may be beneficial.Neuroscience exposure and perceptions of client responsibility among addictions counselorsTimothy A. Steenbergh, Jason D. Runyan, Douglas A. Daugherty, Joseph G. Winger10.1016/j.jsat.2011.09.015Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-24Journal of Substance Abuse Treatment2011-11-24424S0740-5472(11)X0011-9Regular Articles421428http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001760/abstract?rss=yesAbstract: This study examines therapist competency and treatment adherence for a brief intervention addressing alcohol misuse and violent behaviors among adolescents aged 14–18 years. Three observational measures of fidelity were used by independent raters to evaluate 60 therapist-delivered sessions (M = 32.5 minutes). Individual items from the Content Adherence scale, the Global Rating of Competence (Global Rating of Motivational Interviewing Therapist [GROMIT]), and the Self Exploration and Change Talk (SECT) demonstrated fair to excellent interrater reliability (intraclass correlations ranged from .40 to 1.0). Principal components analysis was used to identify the underlying factor structure of the Content Adherence and the GROMIT. Parallel analysis suggested the extraction of three components for the Content Adherence reflecting the three distinct goals for each segment of the intervention. Two components were identified for the GROMIT representing the general spirit of motivational interviewing and empowerment. Findings provide support for the fidelity instruments adapted for this study and offer direction for future training and clinical supervision.Therapist competence and treatment adherence for a brief intervention addressing alcohol and violence among adolescentsStella M. Resko, Maureen A. Walton, Stephen T. Chermack, Frederic C. Blow, Rebecca M. Cunningham10.1016/j.jsat.2011.09.006Journal of Substance Abuse Treatment 42, 4 (2012)2011-11-28Journal of Substance Abuse Treatment2011-11-28424S0740-5472(11)X0011-9Brief Articles429437http://www.journalofsubstanceabusetreatment.com/article/PIIS0740547211001772/abstract?rss=yesAbstract: Although substance abuse treatment programs are important contact points for providing health services for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, availability of services in these programs has not been well characterized. This study evaluated the spectrum of HBV and HCV services offered by substance abuse treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Our survey of substance abuse treatment program administrators covered availability of testing for HBV and HCV; hepatitis A virus (HAV) and HBV immunization; and HCV medical and nonmedical services. There were also questions covering clarity of guidelines for HBV and HCV testing and HAV and HBV immunization. Differences between methadone and nonmethadone programs were examined. Despite the importance of substance abuse in sustaining the hepatitis epidemics, few programs offer comprehensive HBV and HCV testing or HCV health care services. Interventions to improve access to hepatitis services for substance-abusing patients are needed.Hepatitis B virus and hepatitis C virus services offered by substance abuse treatment programs in the United StatesEdmund J. Bini, Steven Kritz, Lawrence S. Brown, Jim Robinson, Donald Calsyn, Don Alderson, Kathlene Tracy, Patrick McAuliffe, Cheryl Smith, John Rotrosen10.1016/j.jsat.2011.09.007Journal of Substance Abuse Treatment 42, 4 (2012)2011-10-31Journal of Substance Abuse Treatment2011-10-31424S0740-5472(11)X0011-9Brief Articles438445