Abstract
BackgroundAlcohol and other drug use disorders contribute substantially to the global burden of illness. The majority of people with substance use disorders do not receive any treatment for their problems, and developing treatments that are attractive and effective to patients should be a priority. However, whether treatment is best delivered in a group format or an individual format has only been studied to a very limited degree. The COMDAT (Combined Drug and Alcohol Treatment) trial evaluates the feasibility, acceptability, and cost effectiveness of MOVE group (MOVE-G) treatment versus MOVE individual (MOVE-I) treatment in four community-based outpatient treatment centres in Denmark.MethodsA two-arm non-inferiority trial comparing MOVE-I (Pedersen et al., Drug Alcohol Depend 218:108363, 2020) with MOVE-G a combined group treatment for both alcohol use disorder and drug use disorder. The primary objective is to examine whether MOVE-G is non-inferior to MOVE-I in relation to abstinence from drug and/or alcohol, number of sessions received, and completion of treatment as planned. All participants will receive treatment based on cognitive behavioral therapy and motivational interviewing, vouchers for attendance and text reminders, as well as medication as needed (MOVE). Participants (n = 300) will be recruited over a one-year period at four public treatment centers in four Danish municipalities. A short screening will determine eligibility and randomization status. Hereafter, participants will be randomized to the two treatment arms. A thorough baseline assessment will be conducted approximately 1 week after randomization. Follow-up assessments will be conducted at 9 months post-randomization. In addition, patients’ use of drugs and alcohol, and patients’ wellbeing will be measured in all sessions. The main outcome measures are drug and alcohol intake at 9 months follow-up, number of sessions attended, and dropout from treatment.DiscussionThe present study will examine the potential and efficacy of combined groups (patients with alcohol and drug disorders in the same group) versus individually based treatment both based on the treatment method MOVE (Pedersen et al., Drug Alcohol Depend 218:108363, 2020).Trial registrationISRCTN88025085, registration date 30/06/2020.
Highlights
Alcohol and other drug use disorders contribute substantially to the global burden of illness
The primary aim of the Combined Drug and Alcohol Treatment (COMDAT) trial is to test the efficacy, feasibility and acceptability of MOVE group (MOVE-G); a treatment that combines Motivational interviewing (MI), CBT, and Contingency Management (CM) in a group format offered to patients with either an alcohol use disorder, a drug use disorder, or both
A Weibull regression model will be estimated using sessions attended as a mediator. The aim of this trial is to contribute to the development of a more structured, transparent, professional, and effective treatment of patients with alcohol use disorder and drug use disorder
Summary
Alcohol and other drug use disorders contribute substantially to the global burden of illness. Individual therapy is still the most used form of treatment for substance use disorders. A large observational study that examined treatment results from 7800 patients [10] concluded that a larger proportion of patients in group therapy had increased likelihood for improved measures of treatment performance compared to patients in individual therapy. In a recent meta analytical review of group therapy for substance abuse disorder in adults [11], thirty-three studies with measures of group therapy outcomes were included. No significant effects were found on substance use frequency, attrition, abstinence rates, wellbeing, and substance use symptoms when compared with individual therapy, which in part was due to the small number of studies for each comparison. In some studies that include patients with certain co-morbid mental health disorders, such as patients with post-traumatic stress disorder, individual therapy has been found to be superior to group therapy [12]
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