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Impact of Enhancements to Smartphone-Based Continuing Care for Alcohol Dependence (J. McKay, PI)
This R01 grant from NIAAA will test whether combining an automated smartphone-based recovery support system with telephone continuing care sessions provided by a counselor improves outcomes over what can be achieved by either intervention alone. Analyses will also test the main effects of each intervention, examine secondary outcomes, and test for hypothesized moderation and mediation effects. Cost-effectiveness analyses will also be conducted. The findings will have major implications for policy decisions regarding efforts to improve the effectiveness and expand the availability of continuing care for alcohol use disorders.
Preventing Risky Drinking in Veterans Treated with Prescription Opioids (J. McKay, PI)
This research supported by the Department of Defense will test an adaptive prevention intervention with Veterans at the Philadelphia Veterans’ Affairs Medical Center who, based on pharmacy records, are using opioids daily to treat chronic pain. The intervention will include adaptive and tailored text messages and telephone contacts. Key components of these services are motivational enhancement and development of more effective ways to cope with stress and other triggers for risky alcohol use. The findings could have a major impact on procedures that monitor and prevent risky alcohol use in patients receiving opioid medication for pain.
Placebo-Controlled, Triple-Blind, Randomized Crossover Pilot Study of the Safety and Efficacy of Four Potencies of Smoked Marijuana in 76 Veterans with Chronic, Treatment-Resistant Post Traumatic Stress Disorder (PTSD) (M. Bonn-Miller, PI)
This grant from Colorado’s Department of Public Health and Environment will test marijuana as a pharmacological agent to manage PTSD symptoms in 76 US military veterans with treatment-resistant PTSD. This will be the first placebo-controlled clinical trial testing the therapeutic potential of marijuana for treating PTSD and is essential for understanding potential risks and therapeutic benefits of marijuana for PTSD patients. Results will provide physicians, patients, scientists and regulators with critical knowledge regarding whether marijuana benefits individuals with PTSD, whether adverse consequences occur, and the impact of varying chemical compositions of marijuana, specifically ∆-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) content, on clinical outcomes.
Treating PTSD with Marijuana: Clinical and Functional Outcomes (M. Bonn-Miller, PI)
Also awarded by the Colorado Department of Public Health and Environment, this observational study aims to complement the placebo-controlled clinical trial by observing and tracking the naturalistic course of clinical and functional outcomes among 150 individuals with PTSD, half of whom report no marijuana use at the start of the study and the other half of whom report regular use of medical or recreational marijuana obtained from a Colorado dispensary. These two groups will be observed over a one-year period to determine differences in the course of PTSD symptoms, the impact of marijuana type and cannabinoid profile on these symptoms, as well as the prevalence and role of marijuana initiation and cessation on PTSD and associated symptoms and functioning. This study, in conjunction with the placebo-controlled clinical trial, will provide important and generalizable information on the safety and efficacy of dispensary-obtained marijuana for long-term PTSD symptom relief.
Predicting AOD Relapse and Treatment Completion from Social Media Use (B. Curtis, PI)
This R01 grant from NIDA will use an open-vocabulary approach to analyze naturally-occurring social media communications to aid our understanding of risk factors, attitudes, and behaviors associated with relapse and dropout in alcohol and drug treatment. This information and other social media monitoring could be used to generate algorithms in the development of relatively inexpensive applications that would monitor patients’ daily behaviors to help prevent the need for more expensive treatment, significantly curtailing healthcare costs. Since relapse and treatment dropout are areas of concern for many chronic medical conditions outside of addictions (e.g., asthma, diabetes), this technology could have widespread benefits in medicine.
Yoga Intervention for Substance Use and ART Adherence in Community Reentry (A. Wimberly, PI)
This F31 grant from NIDA will test a hatha yoga intervention's (HYI) impact on the health outcomes of people recently released from prison with HIV and a substance use disorder. Participants will be randomized to either treatment as usual (TAU) comprised of case management services, or HYI comprised of 12-weekly 90-minute hatha yoga classes in addition to case management services. The study will examine 1) the outcomes of stress, substance use, antiretroviral therapy adherence, viral load, heart rate, and blood pressure; and 2) participants’ perspectives regarding stress, substance use, and yoga as assessed through qualitative interviews. Findings will inform the development of interventions for people with HIV and substance use challenges reentering from prison.
Component Analysis of Motivational Interviewing (J. Morgenstern, PI)
Awarded to the Feinstein Institute for Medical Research at Columbia University, this R01 grant from NIAAA will test the hypothesized mechanisms of behavior change (MOBC) of motivational interviewing (MI). MI is an effective intervention with tremendous implications for a variety of populations suffering from conditions and disorders related to public health, including smoking, gambling, exercise adherence, nutrition, illicit drug use, and alcohol abuse. This R01 builds on a previously implemented pilot study to investigate the mechanisms of change of MI, and the primary goal of the study will be to experimentally manipulate commitment strength, the hypothesized mediator of MI, and demonstrate its relationship to reduced drinking. If its aims are achieved, it will strengthen the efficacy of MI, as well as AUD treatments in general, which can be utilized and implemented in a variety of health settings.
Behavioral Treatment of Adolescent Marijuana Use (A. Budney, PI)
Awarded to the Center for Technology and Behavioral Health of Dartmouth College, this R01 grant from NIDA will test two novel strategies to enhance outcomes in treatment of adolescent marijuana use. Working Memory Training (WMT), an efficacious method for strengthening specific cognitive processes, aims to improve factors (e.g., delay discounting / impulsive decision-making) that have shown a strong relation to substance use and treatment response. Second, more intensive and higher magnitude abstinence incentives (ICM) will be used to motivate abstinence among teens who are not abstinent by Week 6. We hypothesize that these strategies will improve outcomes by modifying a fundamental cognitive system involved in making choices to engage in risky behavior and by increasing motivation to abstain in early non-responders. This project will be the first to evaluate whether Working Memory Training can enhance cognitive function and reduce impulsive decision making to improve abstinence outcomes. In addition, an adaptive abstinence-based incentive program will be evaluated as a new method for intervening with those who do not respond to their first-line treatment. The unique approach holds promise for reducing multiple types of risky behaviors by affecting basic mechanisms that determine impulsive decision-making.
Specialized Community Disease Management to Reduce Substance Use and Hospital Readmissions (A. Brooks, PI)
Awarded to the Treatment Research Institute of Philadelphia, this grant from PCORI will test whether an extended, specialized community disease management program can improve outcomes over an existing nurse navigator disease management strategy for patients with co-morbid medical conditions and SUDs. Patients who meet SUD criteria and have been hospitalized at Temple University Hospital for congestive heart failure, heart attack, or pneumonia are eligible to participate in the study. This research provides an opportunity to demonstrate that treatment for SUDs, skillfully and flexibly applied across inpatient and community settings, can impact the health outcomes and service utilization of inpatients with SUDs, thereby significantly improving patient care while simultaneously reducing overall costs to the system.
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