Ten Take Home Lessons from the First 10 Years of the CTN and 10 Recommendations for the Future

Overview

Journal Am J Drug Alcohol Abuse

Publisher Informa Healthcare

Specialty Psychiatry

Date 2011 Aug 23

PMID 21854269

Citations 15

Authors

Kathleen M Carroll

Samuel A Ball

Ron Jackson

Steve Martino

Nancy M Petry

Maxine L Stitzer

Elizabeth A Wells

Roger D Weiss

Affiliations

Soon will be listed here.

Abstract

Background: The first 10 years of the National Institute on Drug Abuse's Clinical Trials Network (CTN) yielded a wealth of data on the effectiveness of a number of behavioral, pharmacological, and combined approaches in community-based settings.

Methods: We summarize some of the methodological contributions and lessons learned from the behavioral trials conducted during its first ten years, including the capacity and enormous potential of this national research infrastructure.

Results: The CTN made contributions to the methodology of effectiveness research; new insights from secondary analyses; the extent to which approaches with strong evidence bases, such as contingency management, extend their effectiveness to real world clinical settings; new data on 'standard treatment' as actually practiced in community programs, the extent to which retention remains a major issue in the field; important data on the safety of specific behavioral therapies for addiction; and heightened the importance of continued sustained attention to bridging the gap between treatment and research.

Conclusions: Areas of focus for the CTN's future include defining common outcome measures to be used in treatment outcome studies for illicit drugs; incorporating performance indicators and measures of clinical significance; conducting comparative outcome studies; contributing to the understanding of effective treatments of comorbidity; reaching underserved populations; building implementation science; understanding long-term outcomes of current treatments and sustaining treatment effects; and conducting future trials more efficiently.

Citing Articles

Optimizing Contingency Management with Reinforcement Learning.

Kim Y, Brandt L, Cheung K, Nunes E, Roll J, Luo S medRxiv. 2024; .

PMID: 38585900 PMC: 10996730. DOI: 10.1101/2024.03.28.24305031.

Barriers to opioid use disorder treatment among people who use drugs in the rural United States: A qualitative, multi-site study.

Stopka T, Estadt A, Leichtling G, Schleicher J, Mixson L, Bresett J Soc Sci Med. 2024; 346:116660.

PMID: 38484417 PMC: 10997882. DOI: 10.1016/j.socscimed.2024.116660.

Associations of hepatitis C virus (HCV) antibody positivity with opioid, stimulant, and polysubstance injection among people who inject drugs (PWID) in rural U.S. communities.

Estadt A, Miller W, Kline D, Whitney B, Young A, Korthuis P Int J Drug Policy. 2023; :104222.

PMID: 37806839 PMC: 10997735. DOI: 10.1016/j.drugpo.2023.104222.

Dissemination of Contingency Management for the Treatment of Opioid Use Disorder.

DeFulio A Perspect Behav Sci. 2023; 46(1):35-49.

PMID: 37006603 PMC: 10050478. DOI: 10.1007/s40614-022-00328-z.

Peer-based Retention Of people who Use Drugs in Rural Research (PROUD-R): a multisite, randomised, 12-month trial to compare efficacy of standard versus peer-based approaches to retain rural people who use drugs in research.

Young A, Lancaster K, Bielavitz S, Elman M, Cook R, Leichtling G BMJ Open. 2022; 12(6):e064400.

PMID: 35705346 PMC: 9204453. DOI: 10.1136/bmjopen-2022-064400.

References

Proctor E, Landsverk J, Aarons G, Chambers D, Glisson C, Mittman B . Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health. 2008; 36(1):24-34. PMC: 3808121. DOI: 10.1007/s10488-008-0197-4. View

Chambless D, Hollon S . Defining empirically supported therapies. J Consult Clin Psychol. 1998; 66(1):7-18. DOI: 10.1037//0022-006x.66.1.7. View

Prendergast M, Podus D, Finney J, Greenwell L, Roll J . Contingency management for treatment of substance use disorders: a meta-analysis. Addiction. 2006; 101(11):1546-60. DOI: 10.1111/j.1360-0443.2006.01581.x. View

Burlew A, Feaster D, Brecht M, Hubbard R . Measurement and data analysis in research addressing health disparities in substance abuse. J Subst Abuse Treat. 2008; 36(1):25-43. PMC: 4086746. DOI: 10.1016/j.jsat.2008.04.003. View

Norquist G, Regier D . The epidemiology of psychiatric disorders and the de facto mental health care system. Annu Rev Med. 1996; 47:473-9. DOI: 10.1146/annurev.med.47.1.473. View

McHugh R, Barlow D . The dissemination and implementation of evidence-based psychological treatments. A review of current efforts. Am Psychol. 2010; 65(2):73-84. DOI: 10.1037/a0018121. View

Nock M . Conceptual and design essentials for evaluating mechanisms of change. Alcohol Clin Exp Res. 2007; 31(10 Suppl):4s-12s. DOI: 10.1111/j.1530-0277.2007.00488.x. View

Hughes J, Benowitz N, Hatsukami D, Mermelstein R, Shiffman S . Clarification of SRNT workgroup guidelines for measures in clinical trials of smoking cessation therapies. Nicotine Tob Res. 2005; 6(5):863-4. DOI: 10.1080/1462220042000282564. View

McLellan A . Congratulations on the 10-year anniversary of the National Drug Abuse Treatment Clinical Trial Network--now, what's new for the coming decade?. J Subst Abuse Treat. 2010; 38 Suppl 1:S1-3. DOI: 10.1016/j.jsat.2010.02.001. View

10.

Anton R, Randall C . Measurement and choice of drinking outcome variables in the COMBINE Study. J Stud Alcohol Suppl. 2005; (15):104-9. DOI: 10.15288/jsas.2005.s15.104. View

11.

Amaro H, Arevalo S, Gonzalez G, Szapocznik J, Iguchi M . Needs and scientific opportunities for research on substance abuse treatment among Hispanic adults. Drug Alcohol Depend. 2006; 84 Suppl 1:S64-75. DOI: 10.1016/j.drugalcdep.2006.05.008. View

12.

Carroll K, Ball S, Nich C, Martino S, Frankforter T, Farentinos C . Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug Alcohol Depend. 2005; 81(3):301-12. PMC: 2386852. DOI: 10.1016/j.drugalcdep.2005.08.002. View

13.

Babor T, McRee B, Kassebaum P, Grimaldi P, Ahmed K, Bray J . Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abus. 2007; 28(3):7-30. DOI: 10.1300/J465v28n03_03. View

14.

McLellan A, Kemp J, Brooks A, Carise D . Improving public addiction treatment through performance contracting: the Delaware experiment. Health Policy. 2008; 87(3):296-308. PMC: 2736056. DOI: 10.1016/j.healthpol.2008.01.010. View

15.

Martino S, Ball S, Nich C, Frankforter T, Carroll K . Informal discussions in substance abuse treatment sessions. J Subst Abuse Treat. 2008; 36(4):366-75. PMC: 2705985. DOI: 10.1016/j.jsat.2008.08.003. View

16.

Carroll K, Rounsaville B . Computer-assisted therapy in psychiatry: be brave-it's a new world. Curr Psychiatry Rep. 2010; 12(5):426-32. PMC: 2967758. DOI: 10.1007/s11920-010-0146-2. View

17.

Kirby K, Benishek L, Dugosh K, Kerwin M . Substance abuse treatment providers' beliefs and objections regarding contingency management: implications for dissemination. Drug Alcohol Depend. 2006; 85(1):19-27. DOI: 10.1016/j.drugalcdep.2006.03.010. View

18.

Petry N, Kolodner K, Li R, Peirce J, Roll J, Stitzer M . Prize-based contingency management does not increase gambling. Drug Alcohol Depend. 2005; 83(3):269-73. DOI: 10.1016/j.drugalcdep.2005.11.023. View

19.

Regier D, Narrow W, Rae D, Manderscheid R, Locke B, Goodwin F . The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993; 50(2):85-94. DOI: 10.1001/archpsyc.1993.01820140007001. View

20.

McLellan A, Carise D, Kleber H . Can the national addiction treatment infrastructure support the public's demand for quality care?. J Subst Abuse Treat. 2003; 25(2):117-21. View