Therapy For Substance Use Disorders Research Articles

FITNESS FOR RECOVERY- FEASABILITY AND IMPACT OF AN EXERCISE PROGRAM DURING RESIDENTIAL REHABILITATION

INTRODUCTION AND AIMS Opioid use disorder has the lowest quality of life (QOL) and highest disease burden of all substance use disorders (SUD). While opioid treatment does improve QOL, it remains below that of the general population. Previous reviews have indicated that exercise offers benefits for QOL, however the evidence in an opioid treatment population is lacking. This study investigates the feasibility and impact of a 10-week exercise intervention on QOL and mood in a residential rehabilitation program. METHODS Participants admitted to an opioid substitution program within the We Help Ourselves (WHOS) rehabilitation service in Sydney, NSW Australia were invited to participate in a 10-week exercise intervention. Participants completed baseline screening assessing QOL, mood, exercise habits, and a fitness assessment. Willing participants then completed a twice weekly program delivered as part of the group therapy program. Sessions typically consisted of bodyweight exercises such as squats and push ups, and boxing. Following the completion of the training program assessments were repeated. Within group pre-post measures for QOL and mood outcomes were analysed using two-way ANOVA. This clinical trial was registered with Australia New Zealand clinical trial registry (ACTRN12622000213741). RESULTS 45 Participants completed baseline assessments with nine participants completing the intervention and follow up assessment. Significant improvements were seen in QOL (p=0.005), Psychological distress (p<.001), and PCL-5 scores (p=.011). Participants performed well in grip strength, but below norms in all other exercise assessments. Exercise capacity improved following the intervention. CONCLUSIONS Exercise programs are both feasible and beneficial when run as part of SUD improving a range of QOL and mood outcomes. Exercise capacity was generally poor, however improved through the course of the study, often nearing population norms. Exercise should be integrated widely as an adjunct therapy for SUD.

A systematic review and meta-analysis of neuromodulation therapies for substance use disorders

While pharmacological, behavioral and psychosocial treatments are available for substance use disorders (SUDs), they are not always effective or well-tolerated. Neuromodulation (NM) methods, including repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS) may address SUDs by targeting addiction neurocircuitry. We evaluated the efficacy of NM to improve behavioral outcomes in SUDs. A systematic literature search was performed on MEDLINE, PsychINFO, and PubMed databases and a list of search terms for four key concepts (SUD, rTMS, tDCS, DBS) was applied. Ninety-four studies were identified that examined the effects of rTMS, tDCS, and DBS on substance use outcomes (e.g., craving, consumption, and relapse) amongst individuals with SUDs including alcohol, tobacco, cannabis, stimulants, and opioids. Meta-analyses were performed for alcohol and tobacco studies using rTMS and tDCS. We found that rTMS reduced substance use and craving, as indicated by medium to large effect sizes (Hedge’s g > 0.5). Results were most encouraging when multiple stimulation sessions were applied, and the left dorsolateral prefrontal cortex (DLPFC) was targeted. tDCS also produced medium effect sizes for drug use and craving, though they were highly variable and less robust than rTMS; right anodal DLPFC stimulation appeared to be most efficacious. DBS studies were typically small, uncontrolled studies, but showed promise in reducing misuse of multiple substances. NM may be promising for the treatment of SUDs. Future studies should determine underlying neural mechanisms of NM, and further evaluate extended treatment durations, accelerated administration protocols and long-term outcomes with biochemical verification of substance use.

The Impact of Cognitive Behavioral Therapy for Substance Use Disorders on Veterans’ Interpersonal Difficulties

Background: Substance use disorders (SUDs) negatively impact veterans and their relationships with others. Although there are several evidence-based treatments for SUD symptoms, there is less research on whether reduction in SUD symptoms coincides with reduction in interpersonal difficulties. Methods: In this study we examined the relationship between SUD and relationships in a national sample of 458 veterans who received approximately 12 sessions of Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) through the Veterans Health Administration (VHA). Results: Parallel latent growth curve modeling (LGCM) indicated that self-reported alcohol use, drug use, and interpersonal difficulties decreased over the course of treatment. Alcohol and drug use were positively associated with each other and with interpersonal difficulties at each time point, and baseline alcohol and drug use were negatively associated with the reduction of use over time. However, there was little evidence that reductions in substance use led to a reduction in interpersonal difficulties (or vice-versa). Conclusions: Findings highlight promising strategies to further understand how CBT-SUD may enhance reductions in substance use as well as improve relationships with family and friends.

The role of posttraumatic guilt and anger in integrated treatment for PTSD and co-occurring substance use disorders among primarily male veterans.

PTSD and substance use disorders (SUD) frequently co-occur among veterans. Integrated exposure-based treatments, such as Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE), are efficacious in reducing PTSD and SUD symptoms and posttraumatic emotions. This study examines whether guilt and anger (a) decreased in a randomized clinical trial comparing COPE with Relapse Prevention (RP) therapy for SUD and (b) mediated PTSD and SUD symptom reductions or vice versa. Veterans (90.1% men) diagnosed with PTSD and SUD were randomized to 12 sessions of COPE (n = 54) or RP (n = 27). Guilt and anger were assessed at 10 time points during treatment. Multilevel linear models assessed changes in guilt and anger across treatments and lagged multilevel mediation analyses assessed within-subject change in guilt and anger predicting PTSD and percent days of substance use, and vice versa. Guilt (B = -.12, SE = .02, p < .001) and anger (B = -.13, SE = .02, p < .001) improved in both treatments, however guilt was significantly lower in Sessions 7 through 11 among veterans receiving COPE. Improvement in guilt mediated PTSD symptom improvement in both treatment groups (B = -.08, SE = .04, 95% CI [-.16, -.01]), and PTSD symptom improvement mediated anger reduction in COPE (B = -.03, SE = .01, 95% CI [-.06, -.01]). The substance use models were insignificant. Among veterans, integrated, trauma-focused treatments may be associated with greater guilt (directly) and anger (indirectly) reductions due to processing trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Virtual Music Therapy for Substance Use Disorders in a Federally Qualified Health Center.

Music therapy (MT) is an effective adjunctive treatment for substance use disorders (SUD), which is primarily available in inpatient treatment centers and rarely provided in outpatient primary care. We evaluated the feasibility and acceptability of a virtual group MT program for SUD in a Federally Qualified Health Center (FQHC), and secondarily assessed patient perceptions of its effect. Feasibility was measured by implementation-related process measures, attendance and use of technology. Qualitative interviews eliciting participant perceptions were conducted to evaluate acceptability and effect. Mood scores, substance use and craving were measured before and after the intervention. Onboarding of the music therapist took 3.5 months. All MT sessions were attended by 1 to 5 individuals out of 6. Participants reported that group MT was "soothing" and "calming," gave them tools to treat cravings and stress, and created a sense of community. They reported that during sessions their cravings decreased. Anxiety and depression scores trended down, as did the number of days of substance use. They all stated they would seek out MT again. Our results suggest that remote group MT is feasible and acceptable to our FQHC patients with SUD. Patients reported an improvement in mood and their ability to manage stress, and a decrease in substance use. We wish to build on the results of this study to enhance our understanding of the effects of MT in the outpatient setting, and broaden our patients' access to MT in primary care.

Automaticity: schema modes in addiction.

Automaticity is a hallmark of substance use disorder. In Schema Therapy (an evidence-based form of psychotherapy, that has also been applied to substance use disorders), automaticity appears to be a relevant variable. However, the role of automaticity in Schema Therapy has never been made explicit. In the present article, we investigate the role of automaticity in schema modes and its role in different phases in Schema Therapy for substance use disorders. In performing this investigation, we facilitate a better understanding of the working mechanisms of Schema Therapy, and, vice versa, suggest an alternative understanding of automaticity in substance use disorders. We suggest that the automatic use of substances is way of coping with schemas and, therefore, is the consequence of schema mode activity. In the article, four characteristics of automaticity (unconscious, uncontrollable/uncontrolled, efficient, fast) are translated to schema modes. Subsequently, a Schema Therapy case of a patient suffering from an alcohol use disorder and a narcissistic personality disorder is discussed, focusing on the four facets of automaticity. Last, implications for theory, clinical practice and future research are discussed.

Distinct neural networks predict cocaine versus cannabis treatment outcomes.

Treatment outcomes for individuals with substance use disorders (SUDs) are variable and more individualized approaches may be needed. Cross-validated, machine-learning methods are well-suited for probing neural mechanisms of treatment outcomes. Our prior work applied one such approach, connectome-based predictive modeling (CPM), to identify dissociable and substance-specific neural networks of cocaine and opioid abstinence. In Study 1, we aimed to replicate and extend prior work by testing the predictive ability of the cocaine network in an independent sample of 43 participants from a trial of cognitive-behavioral therapy for SUD, and evaluating its ability to predict cannabis abstinence. In Study 2, CPM was applied to identify an independent cannabis abstinence network. Additional participants were identified for a combined sample of 33 with cannabis-use disorder. Participants underwent fMRI scanning before and after treatment. Additional samples of 53 individuals with co-occurring cocaine and opioid-use disorders and 38 comparison subjects were used to assess substance specificity and network strength relative to participants without SUDs. Results demonstrated a second external replication of the cocaine network predicting future cocaine abstinence, however it did not generalize to cannabis abstinence. An independent CPM identified a novel cannabis abstinence network, which was (i) anatomically distinct from the cocaine network, (ii) specific for predicting cannabis abstinence, and for which (iii) network strength was significantly stronger in treatment responders relative to control particpants. Results provide further evidence for substance specificity of neural predictors of abstinence and provide insight into neural mechanisms of successful cannabis treatment, thereby identifying novel treatment targets. Clinical trials registation: "Computer-based training in cognitive-behavioral therapy web-based (Man VS Machine)", registration number: NCT01442597 . "Maximizing the Efficacy of Cognitive Behavior Therapy and Contingency Management", registration number: NCT00350649 . "Computer-Based Training in Cognitive Behavior Therapy (CBT4CBT)", registration number: NCT01406899 .

It is time to broaden community dissemination of cognitive-behavioral therapy for substance use disorders: Charting pathways to ascend the remaining mountainside.

It is time to broaden community dissemination of cognitive-behavioral therapy for substance use disorders: Charting pathways to ascend the remaining mountainside.

An Evaluation of Cognitive Behavioral Therapy for Substance Use Disorder: A Systematic Review and Application of the Society of Clinical Psychology Criteria for Empirically Supported Treatments.

Cognitive behavioral therapy (CBT) is a commonly used treatment for substance use disorders (SUDs) but has not been evaluated using the American Psychological Association's "Tolin Criteria" for determining the empirical basis of psychological treatments. The current systematic review evaluated five meta-analyses of CBT for SUD. One meta-analysis had sufficient quality to be considered in the evaluation of effect sizes. CBT produced small to moderate effects on substance use when compared to inactive treatment and was most effective at early follow-up (1-6 months post-treatment) compared to late follow-up (8+ months post-treatment). Sensitivity analyses including all five meta-analyses found similar results. A "strong recommendation" was provided for CBT as an empirically supported treatment for SUD, based on effects on substance use, quality of evidence, and consideration of contextual factors (e.g., efficacy in diverse populations).

Group Cognitive Behavioral Therapy for Substance Use Disorders Among Psychiatric Inpatients in a Medically Underserved Area: An Intervention for Opioid Misuse.

Opioid misuse is a serious public health concern, yet few people seek treatment for this condition. Hospitals may be one opportunity to identify those with opioid misuse and to teach them skills to help manage their opioid misuse upon discharge. We tested the relationship between opioid misuse status and motivation to change substance use among patients admitted with substance misuse to an inpatient psychiatric unit in a medically underserved area in Baton Rouge, Louisiana, who attended at least 1 group session of motivation enhancement therapy combined with cognitive behavioral therapy (MET-CBT) from January 29, 2020, through March 10, 2022. Of the 419 patients in our sample, 86 (20.5%) appeared to misuse opioids (62.5% male; mean age, 35.0 y; 57.7% non-Hispanic/Latin White). At the beginning of each session, patients completed 2 measures of motivation-importance and confidence to change substance use-from 0 (not at all) to 10 (most). At the end of each session, patients rated perceived session helpfulness from 1 (extremely hindering) to 9 (extremely helpful). Opioid misuse was associated with greater importance (Cohen d = 0.12) and confidence (Cohen d = 0.13) to change substance use and with attending more MET-CBT sessions (Cohen d = 0.13). Patients with opioid misuse rated sessions as highly helpful (score of 8.3 of 9), and these ratings did not differ from patients who used other substances. Inpatient psychiatry hospitalizations may provide an opportunity to identify patients with opioid misuse and introduce these patients to MET-CBT to learn skills to manage opioid misuse upon discharge.

Mobile Health Applications Addressing Health Disparities for Women on Community Supervision: A Scoping Review

Background: Mobile health applications have gained popularity in assisting high-risk, hard-to-reach groups in self-management of health conditions. One such population with high rates of health disparities comprises women under community supervision. In this review, we examine the literature on mHealth applications to address health disparities among women under community supervision. Methods: We searched CINAHL, PubMed, and PsycInfo for peer-reviewed research articles conducted in the U.S. After removal of duplicates, review of 231 article titles and abstracts and 36 articles for full-text review yielded five articles for analysis. Extracted data include author, year, design, sample, objectives, conclusions, measures, interventions and analytic approach. Results: Of the five studies that addressed health disparities of individuals under community supervision, one was done with participants on probation, four with participants on medication therapy for substance use disorder, and one with participants in a drug court program. Only one article was specific to women or controlled for ethnicity. No studies were done with those on parole. None done with populations outside the U.S. Conclusion: Few studies focused on health disparities of women under community supervision. mHealth applications that address substance use, reproductive and sexual health, and safety issues specific to women under community supervision are warranted.

Supplemental Material for An Evaluation of Cognitive Behavioral Therapy for Substance Use Disorders: A Systematic Review and Application of the Society of Clinical Psychology Criteria for Empirically Supported Treatments

Supplemental Material for An Evaluation of Cognitive Behavioral Therapy for Substance Use Disorders: A Systematic Review and Application of the Society of Clinical Psychology Criteria for Empirically Supported Treatments

Substance Abuse: A Public Health Concern

Abstract The context and purpose of the study. Substance abuse is a serious public health concern that affects the millions of people worldwide. It refers to the harmful or hazardous use of psychoactive substances, including drugs and alcohol, that can lead to various health problems, such as addiction, mental health disorders, and physical illness. Alcohol, nicotine, and other illicit drugs are frequently used in excess in substance use disorders, which can impair social, academic, and professional functioning. Cannabis, sedatives, hypnotics, anxiolytics, inhalants, opioids, hallucinogens, and stimulants are the most abused drugs. Throughout human history, substance abuse has been a complex public health issue. The two main approaches frequently used to address the issue of substance abuse are risk factors and treatment modalities. They relate to the various fields of genetic inheritance, physiology, cognitive science, parents, social development, and cultural structures. One of the main issues with public health in today’s culture is drug misuse. Recently, there has been an upsurge in the prevalence of drug usage, especially opioid abuse, worldwide and in Kashmir. This review paper points to a complicated interplay between various variables that affect teenage drug usage. It also describes the different risk factors leading to substance abuse and the various behavioral therapies for substance use disorders that may enhance patient results. As a result, intensive effort across all the levels of domains will be needed to create programmes that prevent teenage substance misuse.

Fitness in recovery: impact of exercise in people with substance use disorder in residential treatment

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Opioid use disorder has the lowest quality of life (QOL) and highest disease burden of all substance use disorders (SUD). While opioid treatment does lead to initial improvements in QOL it remains below that of the general population. The integration of exercise programs as an adjunct therapy for SUD is gaining popularity. Previous reviews have indicated that exercise offers significant benefits for QOL, however the evidence in an opioid treatment population is lacking. This study will investigate the impact of a 12-week exercise intervention on QOL and mood in a residential opioid treatment rehabilitation program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a 12-week single arm intervention with a natural history control. Participants will complete a baseline screening assessing QOL, mood and exercise habits and those who meet criteria for exercise participation will complete an exercise assessment. The exercise program will be delivered twice per week as part of the group therapy program. Exercise sessions will run for approximately 40 minutes and be at an intensity selected by each of the participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A recent review indicated that two sessions of exercise for a minimum of 12 weeks leads to an improvement in QOL in general SUD, however, to date minimal studies have been completed in people receiving opioid agonist treatment. Hence, this will be the first study to our knowledge, assessing the role of exercise as an adjunct treatment for QOL in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial Registration:&lt;/strong&gt; This trial has been registered with the Australian New Zealand clinical trials registry ACTRN12622000213741.&lt;/p&gt;

Does the Augmentation of Trauma Informed Hatha Yoga Increase the Effect of Dialectical Behavior Therapy for Substance Use Disorders on Psychopathological Strain of Patients with Borderline Personality Disorder and Comorbid Substance Use Disorder? Results of a Quasi-Experimental Study

Background: Borderline personality disorder (BPD) is one of the most common personality disorders among persons with substance use disorders (SUDs) and is characterized by severe clinical symptoms. The aim of this study was to investigate if the effect of dialectical behavior therapy for substance use disorders (DBT-S) inpatient treatment on psychopathological symptom load in patients suffering from both BPD and SUD can be augmented by weekly 60-min “Trauma Informed Hatha Yoga” sessions. Materials and Methods: Thirty-nine patients suffering from comorbid BPD and SUD were consecutively in time included in this quasi-experimental pilot study (first intervention then control group). In the intervention group, weekly Trauma Informed Hatha Yoga sessions were added to standard DBT-S for 8 weeks. The participants of the control group received standard DBT-S. All participants completed several self-report questionnaires to assess symptoms of depression, anxiety, symptoms of BPD, and their subjective stress perception at three points in time during the study course. Results: A repeated measures analysis of variance with patients’ psychopharmacological medication as covariate revealed a significant main effect of time for each of the psychometric scales (State and Trait Anxiety Inventory subscale for state anxiety [STAI-S] p = 0.001, Beck Depression Inventory [BDI] p < 0.001; Borderline Symptom List 23 [BSL] p = 0.036) indicating that the psychopathological symptom load of the patients was significantly lower at the end of the DBT-S therapy compared to the beginning in both study groups. Moreover, there was a significant interaction effect of group*time on the psychometric scales STAI-T (subscale for trait anxiety) sum score (p = 0.010) and the sum score of the Perceived Stress Scale (PSS) (p = 0.043). This was expressed by the fact that the participants of the intervention group showed a significant reduction of the STAI-T sum score as well as the sum score of the Perceived Stress Scale (PSS), while the control group did not. Due to the exploratory nature of this study, correction for multiple testing was omitted. Conclusion: Although they are very preliminary, our results suggest that practicing Trauma Informed Hatha Yoga on a regular basis in addition to DBT-S inpatient treatment seems to reduce the level of trait anxiety and perceived stress significantly more than DBT-S inpatient treatment alone. Nevertheless, the effectiveness of Trauma Informed Hatha Yoga in reducing trait anxiety and perceived stress in patients suffering from SUD und BPD must be tested in large randomized controlled trials.

Cocaine Use Disorder (CUD): Current Clinical Perspectives.

Cocaine use disorder (CUD) is a devastating disorder, impacting both individuals and society. Individuals with CUD face many barriers in accessing treatment for CUD, and most individuals with CUD never receive treatment. In this review, we provide an overview of CUD, including risk factors for CUD, common co-occurring disorders, acute and chronic effects of cocaine use, and currently available pharmacological and behavioral treatments. There are no FDA-approved pharmacological treatments for CUD. Future studies with larger sample sizes and testing treatment combinations are warranted. However, individuals with CUD and co-occurring disorders (eg, a mood or anxiety disorder) may benefit from medication treatments. There are behavioral interventions that have demonstrated efficacy in treating CUD – contingency management (CM) and cognitive-behavioral therapy for substance use disorders (CBT-SUD) in particular – however many barriers remain in delivering these treatments to patients. Following the discussion of current treatments, we highlight some promising emerging treatments, as well as offer a framework that can be used in building a treatment plan for individuals with CUD.

Comparing Acute Bouts Of Exercise On Mood And Affect In Females With Substance Use Disorder

Negative mood states experienced during the withdrawal stage of substance dependence have been associated with relapse in persons suffering from substance use disorder (SUD). Exercise is gaining attention as an adjunct therapy for SUD due to its ability to alleviate negative mood states experienced during withdrawal. PURPOSE: To investigate the effects of an acute bout of aerobic and resistance exercise versus control on total mood disturbance (TMD), positive affect (PA), and negative affect (NA) in females enrolled for SUD treatment at inpatient facilities. METHODS: Females (n = 11; 34 + 8 yrs.) were randomly assigned to each condition in counterbalanced fashion. Aerobic exercise (AE) consisted of 20 minutes of moderate intensity (40-60% HRR) treadmill walking, and resistance exercise (RE) consisted of 20 minutes of standardized circuit weight training (8 exercises, 1:1 work to rest ratio). Both exercise interventions included a 5-min warm up and 5-min cool down. C consisted of 30 min quiet reading. The Abbreviated Profile of Mood States (APOMS) was used to assess TMD and the Positive and Negative Affect Scale (PANAS) was used to assess PA and NA pre- and post-treatment. RESULTS: 2 x 3 repeated measures ANOVA indicated TMD was significantly reduced by AE (pre- to post-treatment mean difference (MD) + standard error (SE) 16.55 + 4.76, p = 0.002) and RE (21.55 + 5.59, p = 0.001) but not C (3.00 + 2.9, p = 0.261), with no significant difference between AE and RE. PA was significantly increased by AE (pre- to post-treatment MD + SE 10.36 + 2.31, p = 0.001) and RE (9.82 + 1.74, p = 0.001) but not C (0.27 + 1.70, p > 0.05), with no significant difference between AE and RE. Friedman’s test with Bonferonni-adjusted Wilcoxon signed rank post hoc tests revealed NA was significantly reduced by AE (mean rank difference = 2.864, p = 0.005) and RE (mean rank difference = 2.636, p = 0.014) but not C (mean rank difference 0.955, p = 1.0). CONCLUSION: Acute equivalent-duration bouts of aerobic and resistance exercise are equally effective for acute mood regulation and superior to a physically inactive control in females undergoing inpatient SUD treatment.

Current Trends and Perspectives in the Immune Therapy for Substance Use Disorders.

Substance use disorders (SUDs) are an extremely challenging category of disorders because of the high rate of relapse, lower life expectancy, important rate of psychiatric and somatic co-morbidity, lack of patients' insight during most of the disease duration, healthcare costs, etc. One of the reasons to consider these disorders very difficult for physicians and the healthcare system is the lack of adequate pharmacological agents with long-term proven efficacy. So far, there are no Food and Drug Administration (FDA) or European Medicines Agency (EMA)-approved treatments for most of the SUDs, except for alcohol use disorder, nicotine use disorder, and opioid use disorder. Immunotherapy has been considered a possible solution to SUDs because it may selectively target a certain drug of abuse, it may have a long-lasting effect (several weeks or months), and it ensures an adequate therapeutic adherence. The objective of this paper was to establish the current stage of research in the field of SUDs vaccines, based on a brief literature review. Vaccines for cocaine and nicotine dependence have reached phase III trials, while other researchers are focusing on passive immunization therapy for methamphetamine use disorder. New generations of vaccines are currently explored, and they are based on superior technologies compared to the first generation of immune therapy (e.g., viral transfer genes, more immunogenic adjuvants, or higher specificity haptens). Therefore, finding immune therapies for substance use disorders SUDs remains a matter of interest, and this approach may be useful for the management of an extremely dangerous and versatile psychiatric pathology.

Women's and men's experiences in group therapy for substance use disorders: A qualitative analysis.

This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for substance use disorders (SUDs). Interviews were conducted with 77 women and 38 men after completion of either the gender-specific Women's Recovery Group (WRG) or mixed-gender Group Drug Counseling (GDC). Interviews were coded for themes using a deductive approach with a coding scheme modified from the Stage I trial. Satisfaction was measured quantitatively posttreatment. Participants had high satisfaction scores with no significant differences between groups. Women in GDC rated group gender composition as less helpful than those in WRG. In the GDC group, women more frequently discussed the theme of self-perception (e.g., feelings of comfort, safety, shame) compared with men. Men overwhelmingly expressed the benefits of having women in the group, whereas women expressed advantages and disadvantages of mixed-gender groups and preference for single-gender groups. Guilt and shame were discussed by women and men; however, only women discussed stigma and its important role in their addiction and recovery. Men more frequently endorsed the helpfulness of mixed-gender groups than did women while women appreciated the enhanced support in single-gender SUD groups. Issues of stigma are especially salient for women. Men and women express differences in their experiences of SUD group therapy. Only women endorse stigma as an obstacle to their treatment and recovery. Tailoring treatment to meet women's and men's needs may enhance engagement, retention, and clinical outcomes.

Digital therapeutics for Substance Use Disorders: Research priorities and clinical validation

Abstract Substance Use Disorders (SUDs) have a substantial adverse impact in the United States, with more than $700 billion annually in health care expenditures and lost earnings. 1 The incidence is widespread; approximately 21.6 million individuals over the age of 12 experience substance use or dependence. 1 There are safe and effective FDA approved pharmacological treatments for opioid and nicotine use disorders, but long-term SUD treatment remains challenging. Similarly, despite available efficacious behavioral therapies for SUDs delivered in-person by trained professionals, relapse rates are high. As evidenced during the COVID-19 pandemic, traditional methods of delivering treatment have limitations and can be difficult or even impossible to access. Therefore, additional treatments for SUDs are urgently needed. Digital therapeutics (DTx) represent a new opportunity to address this significant public health challenge and were recently identified by the White House Office of National Drug Control Policy (ONDCP) in the priority to expand access to evidence-based treatment including “reimbursement for motivation incentives and digital treatment for addiction.”