United States Aims Research Articles

Staff acceptability of contingency management to promote longer breastfeeding duration at WIC

Staff acceptability of contingency management to promote longer breastfeeding duration at WIC

Patient pre-treatment expectations and substance use treatment outcomes

Drug and Alcohol Dependence 156 (2015) e183–e245 e201 conducted utilizing a subset of the NSCAW II in which the children remained in the home following a CPS investigation. A random half sample was drawn (n=1087) to conduct two separate models for female and male caregivers. Results were confirmed on the second half of the sample. PDU was measured continuously with the 20-itemDrugAbuse Screening Test. Caregiver depressionwasmeasuredwith the Composite InternationalDiagnostic Interview-Short Form. CIB was measured continuously with the internalizing subscale of the Child Behavior Checklist. Control variables were child age, child gender, and familypoverty. Analyses accounting for stratification, clustering, andweightingwere conductedwithMplus 7.0. Standardized estimates and asymmetrical confidence intervals are reported. Results: Female caregivers’ depressionwas found to fullymediate the relationship from PDU to CIB ( = .048, ⌠= .015, 95% CI .021–.081). Among male caregivers, depression was not a significantmediator in the relationship fromPDU toCIB ( = .007, ⌠= .039, 95% CI−.068 to .099). Fit for the female caregivermodel was strong (RMSEA= .000, p= .99; CFI = 1.00). Conclusions: Among families reported to CPS where a female caregiver is engaged in PDU, thepresence of comorbiddepression is an important indicator of need for intervention. Addressing these comorbid disorders may lead to decreases in CIB. Unavailable in this dataset, future research should examine anxiety as another potential mediator. Financial support: F31DA034442; T32DA015035; Doris Duke Fellow; Fahs-Beck Scholar. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.540 Patient pre-treatment expectations and substance use treatment outcomes Kelly Serafini2,∗, Suzanne Decker2,3, Brian D. Kiluk1, Luis Anez2, Manuel Paris2, Tami Frankforter2, Kathleen M. Carroll 2 1 Psychiatry, Yale School of Medicine, West Haven, CT, United States 2 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, United States 3 West Haven VA, West Haven, CT, United States Aims: To determine if expectations at pre-treatment are associated with substance use treatment outcomes. Methods: Treatment expectations were examined in two randomized controlled trials (RCTs) utilizing Motivational Enhancement Therapy (MET) for the treatment of substance use conducted in the CTN. One RCT was delivered in English (MET-E) and one was delivered in Spanish (MET-S). There were 461 participants MET-E sample and 405 participants MET-S. Participants responded to the following item at pre-treatment: “Do you think you will reduce or stop your use of drugs or alcohol as a result of this treatment?” ANOVAs and chi-square tests were used to examine the relationship between treatment expectations and treatment outcomes in the two samples. Results: Treatment expectations were not associated with any of the treatment outcomes in MET-E. However, in MET-S, expectationswere significantly associatedwithmost of the post-treatment outcomes. Among these, treatment expectationswere significantly associated with the percentage of drug positive urines within the treatment period, F (1, 1,163) =18.83, p= .000, and the percentage of days abstinent from primary drug use while in treatment and through follow-up, F (1, 1,364) =23.78, p= .000. Conclusions: There are several possible interpretations to the divergent findings between samples. The first is that the MET-S sample had fewer previous treatments, and that when a treatment is novel, expectations may have more of an influence. The second interpretation is that there may be cultural components that may affect how an individual relates to the treatment process. These findings are preliminary and future research should examine treatment expectations across cultures. Financial support: This research was supported in part through a National Institute on Drug Abuse (NIDA) T-32 grant, 5T32DA007238-23 (Petrakis), anduseddata fromstudies thatwere funded by the Clinical Trials Network. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.541 Does craving intensity influence cue exposure reports? An ecological momentary assessment study in patients with alcohol, tobacco, cannabis and heroin use disorder F. Serre1,∗, M. Fatseas1, J. Swendsen2, Marc Auriacombe1 1 Addiction Psychiatry (CNRS USR 3413), Universite Bordeaux, Bordeaux, France 2 CNRS UMR 5284 INCIA University Bordeaux,

Correlates between Brazilian club drug users men who have sex with men, psychiatric vulnerabilities and multiple sexual partners

Drug and Alcohol Dependence 156 (2015) e183–e245 e189 areas of sexual risk reduction, prevention and treatment for substanceabuseandmental health. Publichealthprogramsprioritizing the different populations are necessary. Financial support: Fogarty International Center; Grant 1R03TW007612; Fundo de Incentivo e Auxilio a Pesquisa (FIPE) from Hospital de Clinicas de Porto Alegre, Brazil (GPPGHCPA – No. 07-391). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.507 Crack, powdered cocaine, both or neither: A generalized logit analysis of a community-based sample Grace L. Reynolds1,2,∗, Dennis G. Fisher1, Erlyana Erlyana2 1 Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA, United States 2 Health Care Administration, California State University, Long Beach, Long Beach, CA, United States Aims: To understand factors associated with use of both crack cocaine and non-injected powered cocaine. Methods: The Risk Behavior Assessment (RBA; 1993) was used to elicit information on past month, past 48-hours and drugs used before/during sex drug use in a sample of out-of-treatment drug users (N=8538). Past 30 day, past 48h, and before/during sex drug use were coded into (1) use of crack (smokable cocaine) only, (2) powdered cocaine use only, (3) both drugs used during the timeframe and (4) neither drug used. Generalized logit analysis was used to develop models for each timeframe (48-hour and 30-day). For all models the reference group was using neither drug. Results: Respondents who reported use of both crack and powdered cocaine (N=306) included both men (n=207) and women (n=99). The 48-hour, 30-day, and before/during sex models were almost identical. Those who reported using both crack and cocaine were more likely to: be Black (OR=1.65, CI 1.27, 2.14); bisexual (OR=1.85, CI 1.39, 2.47); trade sex fordrugs (OR=4.88CI 3.73, 6.39); tobehomeless (OR=3.50, CI 2.66, 4.62), havehighernumberof days used alcohol in the pastmonth (OR=1.09, CI 1.08, 1.10); and to have had gonorrhea (OR=1.42, CI 1.07, 1.88). Conclusions: The general logit model highlights factors associated with use of both crack and powdered cocaine within the same timeframe, includinghomelessness, andbeingamemberof anethic or sexual minority, and sex trading. Financial support: Funding was provided in part by grant R01 DA030234 from the National Institute on Drug Abuse, P20MD003942 from the National Institute of Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute ofMinority Health and Health Disparities or the National Institutes of Health. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.508 Cannabis users show increased susceptibility to false memories Jordi Riba1,∗, Frederic Sampedro2, Aina Rodriguez-Pujadas2, Saul Martinez-Horta1, Jaime Kulisevsky1, Jose-Carlos Perez-de-los-Cobos1, Antoni Rodriguez-Fornells1, Marta Valle1 1 Hospital Sant Pau, Barcelona, Spain 2 University of Barcelona, Barcelona, Spain Aims: Previous studies on the neurocognitive impact of cannabis use have found working and declarative memory deficits that tend to normalize with abstinence. An unexplored aspect of cognitive function in chronic cannabis users is the ability to distinguish between veridical and illusory events; a crucial aspect of reality monitoring that relies on adequate memory function and cognitive control. Methods: Sixteen heavy cannabis users not seeking treatment for their cannabis consumptionwerematched to a group of healthy controls taking into account sex, age, years of education, verbal intelligence and fluid intelligence. All participants performed a modified version of the Deese–Roediger–McDermott paradigm in an MRI scanner. Following a study phase, subjects were presented with 75 old words, 40 semantically unrelated new words and 40 semantically related new words or lures. They were required to judge whether a word had been presented in the study phase and make an old vs. new decision by button press. Results: Cannabis users showed an increased susceptibility to false memories, failing to identify lure stimuli as events that never occurred. In addition to impaired performance, they displayed reduced activation in areas associated with memory processing within the medial temporal lobe (MTL), and in parietal and frontal brain regions involved in attention and performance monitoring. Reduced activity in the MTL was associated with greater cannabis consumption. Conclusions: These findings indicate that cannabis users have an increased susceptibility to memory distortions even when abstinent and drug-free, suggesting a long-lasting compromise of memory and cognitive control mechanisms involved in reality monitoring. Financial support: This research was supported by the “Plan Nacional Sobre Drogas” of the Spanish Government. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.509 CaMKII inhibition affects cocaine-cue memory processes to attenuate reinstatement Matthew T. Rich1,∗, Mary M. Torregrossa2 1 University of Pittsburgh, Pittsburgh, PA, United States 2 Psychiatry, University of Pittsburgh, Pittsburgh, PA,

Le MIR, la révolution et ses classes sociales dans le Chili des années 1960

This paper focuses on the years preceding Salvador Allende’s Popular Unity in Chile (1970-1973) and, more precisely, on the Movimiento de Izquierda Revolucionaria (MIR). Since 1969, this Marxist revolutionary group had actively participated in the class struggle in Chile. However its political and social activism was not oriented towards the working class, but instead towards marginalized social sectors (inhabitants of informal settlements and landless rural workers). The paper thus seeks to elucidate the process which led the MIR to invest social sectors that should have been considered as “unorthodox,” from a Marxist organization’s point of view. More generally, the analysis of a political experience taking place in a country where the working class was not as coherent or as massive as it was in 20th Century Western Europe and the United States aims at “deprovincializing” history and at using the concepts of “class” and “class struggle” in a manner which distances them from their potentially economicist and sociologizing implications.

Risk of polysubstance use and co-occurring internalizing and externalizing symptoms among adolescent sexual minority girls

Risk of polysubstance use and co-occurring internalizing and externalizing symptoms among adolescent sexual minority girls

Implementing opioid overdose education and naloxone distribution in an outpatient community treatment program

Implementing opioid overdose education and naloxone distribution in an outpatient community treatment program

Changes in attentional bias to drug cues and fMRI Stroop with behavioral treatment for cocaine dependence

Changes in attentional bias to drug cues and fMRI Stroop with behavioral treatment for cocaine dependence

Longitudinal gender differences in HIV and criminal justice outcomes

Longitudinal gender differences in HIV and criminal justice outcomes

Is opioid dose a strong predictor of the risk of opioid overdose? Important confounding factors that change the dose–overdose relationship

Is opioid dose a strong predictor of the risk of opioid overdose? Important confounding factors that change the dose–overdose relationship

Incentives in public addiction treatment payment systems: Intended and unintended effects

s / Drug and Alcohol Dependence 146 (2015) e34–e117 e79 reductions inwithdrawal and urges frombaseline through the final treatment week. Conclusions: Depressed and non-depressed smokers differed onpatterns ofwithdrawal andurges to smoke,with those reporting depression showing increased withdrawal and urges when they initially reduced smoking. Financial support: NIH R21DA021839, R01DA034537, Helene Lycacki/Joe Young, Sr. Funds (Michigan). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.582 Incentives in public addiction treatment payment systems: Intended and unintended effects Sharon Reif, Maureen Stewart, Constance M. Horgan, B. Mohr Institute for Behavioral Health, The Heller School, Brandeis University, Waltham, MA, United States Aims: Innovative ways are needed to improve the quality of treatment for drug use disorders. Performance-based contracting (PBC) aims to align program incentives and purchaser goals, yet is uncommon indrugabuse treatment systems. In2007,Maine implemented a second-generation PBC systemwith financial incentives, for outpatient programs, addressing problems identified with its previous PBC. This study aims to (1) determine whether rewarded measures and outcomes changed under the PBC, (2) examine whether there was client selection due to the PBC and (3) explore possible unintended effects of the PBC. Methods: We use state administrative data from 2005 to 2011 andmultilevelmodeling techniqueswithadifference-in-difference approach, and a non-PBC comparison group, to determinewhether the 2007 PBC resulted in improved access and retention in treatment and whether positive or negative unintended effects stemmed from it. Results: Preliminary analyses (N=25,105 admissions) indicated that the probability of receiving four or more outpatient treatment sessions did not change significantly between the 2005–2007 preperiod and the 2008–2011 post-period (OR .9, p= .16) and was not significantly different in the PBC agencies from the non-PBC agencies. Similarly there was no significant change in the probability of remaining in treatment for 90 days or more. The most significant predictors of retention were client characteristics (previous treatment, criminal justice involvement and homelessness). Client selection problems were not identified in an analysis of admission rates for individualswith diagnosedmental disorders.We continue to refine these models and examine the impact of the PBC on other factors and client outcomes. Conclusions: Introduction of a PBC is a significant change in payment design that may affect how drug treatment services are delivered, thus increasing our understanding of its effects is critical. Inpreliminary analyseswefind theoverall net effect of incentivized contract very small and not significant. Financial support: NIDA R01 DA033402. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.583 A comparison of drug-related deaths in Florida, 2007–2012 C.J. Reissig, J.M. Vojtech Health and Human Services, U.S. Food and Drug Administration, Silver Spring, MD, United States Aims: The state of Florida maintains extensive and publicly available death records data tracking a variety of prescription and recreational drugs of abuse. The aim of this study was to examine the most frequently occurring drug-related deaths in Florida from 2007 to 2012. Conclusions: Drug-related death data were obtained from the state of Florida for the years 2007–2012. The leading causes of drug-related deaths in Florida from 2007 to 2012 involved opioids and benzodiazepines. The Florida death data were sorted by the type of drug(s) involved in death: amphetamines, ethanol, benzodiazepines, inhalants, opioids or “other.” Preliminary analyses examined specific drugs that were present at death including hydrocodone, oxycodone, alprazolam, and carisoprodol. Data were sorted to observe the numbers of deaths per year, and the number of deaths classified as “causal” or “present.” Finally, we examined the number of deaths that occurred when each drug was used in combination with one or more other drugs. The majority of deaths occurred when oxycodone and hydrocodone were used in combination with at least one other substance. Alprazolam was the most common drug found in combination with hydrocodone or oxycodone. Financial support: N/A. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.584 Sex and drugs in the lives of minority women: A multi-level analysis of smartphone-based daily diary data Grace L. Reynolds1, Dennis G. Fisher1, Jean-Philippe Laurenceau2 1 California State University, Long Beach, Long Beach, CA, United States 2 University of Deleware, Newark, DE, United States Aims: African American and Latina women are at increased risk of HIV infection through heterosexual contact. Daily smartphonebased diaries can provide event-level information about the context of sex and drug use behaviors that may help in our understanding of why heterosexual contact is so risky for minority women. Theaimof this researchwas to investigatedruguse and sex risk through the use of electronic daily diary collection methods. Methods: 189 women were recruited into a smartphone daily diary study for a 12-week (84 days) diary period. Baseline interviews were completed and women consented to completing a data collection “app” using Samsung Android smartphones with unlimited text, Internet and voice capability provided by the study. Weekly incentiveswere provided for daily diary completion.Mplus was used for the multi-level analysis which specified a withinsubjectsprocesswherewepredicted thathigh-risk sexwouldoccur on days on which women also used illicit drugs.

Evaluation of lisdexamfetamine alone and lisdexamfetamine + modafinil for cocaine use disorder

s / Drug and Alcohol Dependence 146 (2015) e202–e284 e231 Financial support: NIH NIDA 5R01DA019999 and 5T32DA022981; NIH CTSA program UL1T39 and KL2T63. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.094 Evaluation of lisdexamfetamine alone and lisdexamfetamine+modafinil for cocaine use disorder Alex Brewer1, Daisy G. Thompson-Lake2, James J. Mahoney2, Thomas F. Newton2, Richard De La Garza II 1,2 1 Pharmacology, Baylor College of Medicine, Houston, TX, United States 2 Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States Aims: Modafinil and sustained release (SR) amphetamine (AMPH) have each shown efficacy for cocaine use disorder, albeit with equivocal results. We hypothesize that a combination medications approachmay bemore efficacious for cocaine use disorder. Thespecificaimof this study is todetermine theeffectsof treatment with lisdexamfetamine alone, and lisdexamfetamine+modafinil, versus placebo, on the subjective and reinforcing effects produced by cocaine in non-treatment-seeking individuals with cocaine use disorder. Methods: In this ongoing study, participants are being recruited from the Houston metropolitan area. All participants meet DSM-IV criteria for cocaine use disorder, and are not seeking treatment. Participants are randomized to placebo, lisdexamfetamine (30mg/day), ormodafinil (200mg/day) + lisdexamfetamine (30mg/day) for 4 days. On day 4, participants complete two selfadministration sessions involving 5 choices for either cocaine (20mg/infusion) or saline. Primary outcome measures include number of choices made for cocaine/saline, and changes in subjective effects and cardiovascular measures. Results: To date, the majority of enrolled participants (N=18) are African American males who smoke cocaine. The majority of individuals also smoke cigarettes, anduse alcohol andmarijuana. In comparison to saline, exposure to cocaine resulted in significantly greater choices for an infusion, increased heart rate and blood pressure, and greater self-reports of positive subjective responses (e.g., “High”, “Any Drug Effect”) (all p’s <0.001). To date, no medication effects have been observed among treatment groups as compared to placebo. Conclusions: Thepreliminaryanalysesdidnot reveal any significant effects produced by the test compounds; however, the group sizes are small (N∼6/group) and data collection is ongoing (final N=20/group). Financial support: Supported by DA023625 (DLG). This work was conducted at, and supported by, the Michael E. DeBakey VA Medical Center, Houston, TX, USA. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.095 Screening and brief treatment for illicit drug use in primary care: Feasibility and acceptability Adam C. Brooks1, Carolyn M. Carpenedo1, Jennifer Lauby2, David Metzger1,3, Elizabeth Byrne2, Kevin Favor4, K.C. Kirby1,3 1 Treatment Research Institute, Philadelphia, PA, United States 2 Public Health Management Corporation, Philadelphia, PA, United States 3 Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States 4 Department of Psychology, Lincoln University, Lincoln University, PA, United States Aims: Brief intervention in primary care settings for illicit drug use has a mixed track record in reducing drug use. We are conducting a randomized clinical trial of a brief intervention (SBIRT) against a 2–6 sessions intervention of brief treatment in three urban federally qualified healthcare centers (FQHCs). Feasibility and acceptability results are reported here. Methods: Primary care patients were screened for risky substance use (alcohol and drug) as they attend regularly scheduled appointments. Consenting patients who screened positive were randomized to receive: (1) SBIRT, conducted in one session and boosted with a 10–15min follow-up within the next month, or (2) SBIRT+, 2–6 sessions incorporating MET, CBT, and boosted with ongoing monthly brief recovery check-ups. Results: 7162 patients were prescreened, and 745 patients demonstrated drug or alcohol risk on the DAST or AUDIT; 414 patients have currently enrolled. Enrolled patients demonstrate a relatively even split between primary alcohol (35%), primarymarijuana (37%) and other illicit drugs (28%). Patients reported frequent drinking days (M=10.07, SD=9.89) and days of drug use (M=14.63, SD=12.08) in the past 30 days. Engagement with both study conditions has been acceptable; SBIRT+ patients attended M=3.56 sessions (SD=1.74). Patient satisfaction and perception of utility regarding clinical procedures has been very high. Approximately 49% of patients to date have been referred to addiction treatment, and 24% have entered treatment. Conclusions: Screening and onsite brief intervention/brief treatment is feasible in urban FQHCS. Heavy substance users enrolled in an ongoing trial in primary care find returning for multiple brief treatment sessions acceptable. Financial support: Commonwealth of Pennsylvania Department of Health SAP 4100055578. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.096 Evaluation of an electronic information system to enhance practice at a medication-assisted opioid treatment program Lawrence S. Brown, Steven Kritz, Melissa Lin, Ben Louie, Roberto Zavala START Treatment and Recovery Centers (formerly ARTC), Brooklyn, NY, United States Aims: START is an outpatient substance abuse program that provides primary care for approximately 3000 adults in NYC. We received funding to evaluate implementation of an electronicmedical record integrating all services. Methods: Quality, Satisfaction, Productivity, and Financial Performance were evaluated utilizing a pre and post-implementation research design. The capabilities of the electronic system were utilized to evaluate Quality, Compliance, and Productivity in all

Cognitive-behavioral therapy and educational counseling for chronic pain and opioid dependence

Cognitive-behavioral therapy and educational counseling for chronic pain and opioid dependence

How important are counselor and client characteristics in determining overall client satisfaction with 12-step focused community counseling groups?

s / Drug and Alcohol Dependence 146 (2015) e202–e284 e217 Developmental heritability of internalizing symptoms and cigarette use co-occurrence Cristina B. Bares1, Kenneth S. Kendler3,2, Judy Silberg2 1 School of Social Work, Virginia Commonwealth University, Richmond, VA, United States 2 Department of Human Genetics, Virginia Commonwealth University, Richmond, VA, United States 3 Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States Aims: Previous research with adult twins has indicated that additive genetic factors contribute substantially to the association between adult internalizing symptoms and cigarette use. This study was conducted to examine how the contribution of genetic and shared environmental factors to the co-occurrence between internalizing symptoms and cigarette use among adolescent twins change during adolescence. Methods: Adolescent twin pairs (n=1258) came from the population-based Virginia Twin Study of Adolescent Behavioral Development. Age-specific bivariate twinmodelingwas performed of the highest number of cigarettes smoked and a composite measure of anxious and depressive symptoms from the Child and Adolescent Psychiatric Assessment. Saturated bivariate Cholesky models for two age groups (14to 15-, and 16to 17-year-olds) were compared to reduced models where additive genetic and shared environmental influenceswere systematically removed and the fit of the nested models compared using OpenMx. Results: Compared to the saturated bivariate Cholesky, including three sources of genetic variance, a model dropping shared environmental effects caused a reduction in model fit for both groups (x2(3, n=582) =10.73, p< .01; x2(3, n=676) = , p< .01). The best fitting models indicated that 40.9% (for 14 to 15-y-o) and 37.5% (for 16to 17-y-o) of the total variance was explained by shared environmental factors common to both cigarette use and internalizing symptoms. Conclusions: The co-occurrence between internalizing symptoms and cigarette use among a sample of adolescent twins appears to result from decreasing shared environmental factors that influence the risk to both traits. Financial support: Funding for Dr. Bares’ work comes from Dr. James Anthony’s R25 DA030310. Funding for the Virginia Twin Study of Adolescent Behavioral Development comes from the following NIH grant, MH-45268. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.057 How important are counselor and client characteristics in determining overall client satisfaction with 12-step focused community counseling groups? Rita Baroni1, Douglas Boyd1, Adam Christmann1, Emily Hutz1, Carolyn M. Carpenedo1, Adam C. Brooks1, Alexandre B. Laudet2, K.C. Kirby1,3 1 Treatment Research Institute, Philadelphia, PA, United States 2 National Development and Research Institutes, New York, NY, United States 3 University of Pennsylvania School of Medicine, Philadelphia, PA, United States Aims: Research indicates that client satisfaction at end of treatment is associated with successful treatment outcomes. The present study examines client satisfaction in community counseling groups and counselor and client characteristics associatedwith increased satisfaction. Methods: In a pre-intervention phase of a large, multi-phase, multi-site clinical trial, 80counselors completedabackground form and agreed to run five group sessions on 12-step facilitation (12SF) topics,withminimal trainingandcovering the content to thebest of their current knowledge and ability. 700 clients in the counselors’ groups also agreed toparticipate and completed abackground form prior to attending groups. After the fifth session, clients rated their satisfactionwith the 12SF groups on both general and 12SF specific items. Results: Binary logistic regression for general satisfaction showed that clients under judicial pressure to be in treatmentwere 46.3% less likely to be very satisfied (OR= .573, p= .003), whereas clients whose counselors had more years of experience were more likely to be very satisfied (OR=1.04, p= .007). For 12S specific satisfaction, clients under judicial pressure were 44.9% less likely to be very satisfied (OR= .551, p= .000) and clients who had counselors that identified as being in recovery were 80flmore likely to be very satisfied (OR=1.80, p= .037). Conclusions: These results suggest that certain client and counselor characteristics are associated with client satisfaction with group counseling, and thus could influence client outcome. Treatment providers may need to (1) develop different strategies to foster higher satisfaction among criminal justice populations, and (2) focus on providing additional training on 12SF to less experienced counselors or those not in recovery in order to increase satisfaction. Financial support: NIAAA R01 AA017867. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.058 Substance use and mental health consequences of childhood trauma: An epidemiological investigation Emma L. Barrett, Maree Teesson, Cath Chapman, Tim Slade, Natacha Carragher, Katherine Mills National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW,

Risky behaviors on the road: Do women and men act differently after drinking?

s / Drug and Alcohol Dependence 146 (2015) e34–e117 e105 Risky behaviors on the road: Do women and men act differently after drinking? Tanara R. Sousa1, Graciela Pasa1, Jeffrey Lunnen2, Flavio P. Pechansky1 1 Center for Drug and Alcohol Research, Federal University of Rio Grande do Sul, Porto Alegre, Brazil 2 Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States Aims: To compare differences between female andmale drivers regarding select risk factors in two Brazilian cities receiving intervention as part of the Global Road Safety Project. Methods: A knowledge, attitude and perception (KAP) survey was conducted among drivers in Palmas and Teresina. In October and November 2013, 1556 face to face interviews were conducted; samplingwasdonebyquotas, according todriver’s sex (70.9%male) and age. Results: The results show that females and males behave differently on the road. Females reported drinking and driving less (41.1% vs. 64.9% – p lofexidine (0.3mg/kg) = clonidine (0.3mg/kg) > guanfacine (1.8mg/kg). In drug discrimination studies, the discriminative stimulus effects of a cocaine-heroin mixture were not significantly altered by doses of brimonidine, guanfacine or clonidine below those that produced sedative effects and decreased operant responding to 50% decrease in the intake of cocaine/heroin mixtures without consistent modulation of their reinforcing strength. Conclusions: These data indicate that doses of alpha-2 agonists with behavioral side-effects that diminish over repeated treatment may be useful for in the management of polydrug (cocaine/heroin) addiction. Financial Support: (supported by DA 031299) http://dx.doi.org/10.1016/j.drugalcdep.2014.09.653 Differential effects of the benzodiazepines alprazolam and oxazepam on methamphetamine-related behaviors in rats Allyson Spence, Glenn F. Guerin, Nicholas E. Goeders Pharmacology, Toxicology, & Neuroscience, LSU Health Sciences Center, Shreveport, LA, United States Aims:Drugusers often combinebenzodiazepineswithpsychostimulants, such as methamphetamine (METH). Previous research has shown that not all benzo-diazepines have the same potential for abuse.While alprazolam (ALP) is highly preferred by drug users, oxazepam (OX) has a far lower abuse potential. We hypothesized thatMETHwould induce conditioned place preference (CPP), while OX and ALP would block the METH-induced CPP. We hypothesized that OX and ALP would attenuate METH discrimination. Methods: CPP was conducted to study the reward potential of the benzodiaz-epines OX and ALP when combined with METH to simulate polydrug abuse in rats (n=8/group). To determine if ALP and/orOXwouldalter the subjective effects ofMETH,wealso investigated the effects of these drugs on the discriminative stimulus effects of METH in rats (n=7/group). Rats were trained to discriminate METH (1.0mg/kg, ip) from saline using a two-lever operant, food-reinforced, drug discrimination design. The effects of ALP (2 and 4mg/kg, ip) and OX (5, 10, and 20mg/kg, ip) on METH discriminationwere determined by administering these drugs prior to variousdoses ofMETH (0, 0.125, 0.25, 0.5, 1, or 2mg/kg, ip) and then measuringwhether the rat pressed theMETHor saline-associated lever. Data were analyzed using one-way ANOVA. Results: METH produced a CPP, and OX blocked this METHinduced CPP. However, ALP did not block the METH-induced CPP. OX significantly attenuatedMETH discrimination in rats. However, we found that thehighdoseofALPaugmented the subjectiveeffects of lower doses of METH. Conclusions: The results of these experiments suggest that OX and ALP can differentially affect meth-related behaviors. OX attenuates the rewarding properties as well as the subjective effects of METH, while ALP may actually increase the rewarding properties of lower doses of METH. Future research will aim to identify the

The role of self-efficacy in predicting perinatal women's ability to reduce smoking

The role of self-efficacy in predicting perinatal women's ability to reduce smoking

A remote wireless sensor network/electrocardiographic approach to discriminating cocaine use

s / Drug and Alcohol Dependence 146 (2015) e202–e284 e209 Conclusions: These data indicate that there is an interactive relationship between mPFC 5-HT2AR and 5-HT2CR that may drive impulsive phenotypes. Methylation patterns of these genes maymediate a gene× environment interaction to control inherent impulsivity, such that high impulsivity associates with higher 5HT2CR methylation in a critical brain region linked to impulsivity. Thus, we have uncovered potential neurobiological mechanisms of importance in driving inherent impulsivity. Financial support: DA033374, UL1T71, DA024157, DA020087. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.035 Workforce attitudes regarding the implementation of extended release naltrexone to treat opioid dependence Laura Andrich1, Katherine T. Garvey1, Elias M. Klemperer2,1, Traci R. Rieckmann1 1 Oregon Health & Science University, Portland, OR, United States 2 University of Vermont, Burlington, VT, United States Aims: Prior research indicates that organizational and workforce characteristics influence the implementation of evidencebased treatments. This study examined the workforce’s response to the utilization of extended release naltrexone to treat opioid addiction at time one (n=36) and time two (n=30). It explores staff opinions toward the implementation of a new medicated assisted treatment (MAT) for opioid addiction and documents the integration of an FDA approved treatment in an in-patient addictions facility. Methods: A mixed-methods approach was employed using semi-structured interviews and a quantitative survey with the staff at the addictions facility. Participants were support staff who interacted with patients. The quantitative survey was administered early in the new MAT program implementation (n=36) and again six months later (n=30). Data were analyzed using STATA and included descriptive statistics, correlations t-tests, and analyses of variance. Atlas-ti software was used to analyze codes in the qualitative data regarding attitudes and opinions about MAT. Results: Data from the survey suggest that over time,workforce knowledge about the new MAT increased (33.33–77.78%). There was also a slight increase inworkforce opinion that their coworkers supported the use of the newMAT (11.11–51.85%) as well as opinion that their supervisors supported the newMAT (48.57–70.37%), indicating an increase in perceived social support. The qualitative data indicate the importance of housing and peer support to successful recovery. Conclusions: Our findings indicate that counselors and support staff play a critical role in the adoption of efficacious MATs, with perceived social support at time two ranging from 51.85% for supervisors and 77.78% for coworkers. Greater attention to staff attitudes and perspectives when working to accelerate utilization of medications are recommended for improved patient outcomes. Financial support: This work was supported by the Hooper Detoxification Stabilization Center Vivitrol® Pilot Program State Funded Evaluation Project. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.036 A remote wireless sensor network/electrocardiographic approach to discriminating cocaine use Gustavo A. Angarita1, Annamalai Natarajan2, Edward C. Gaiser1, Abhinav Parate2, Benjamin Marlin2, Ralitza Gueorguieva3, Deepak Ganesan2, Robert T. Malison1 1 Psychiatry, Yale University School of Medicine, New Haven, CT, United States 2 School of Computer Science, University of Massachusetts, Amherst, MA, United States 3 Biostatistics, Yale University School of Medicine, New Haven, CT, United States Aims: To establish the sensitivity/specificity of a RWSN/ECG approach for discriminating cocaine use from other cardiovascular stimulants. Hypothesis: Wearable “on body” sensors will reliably distinguish cocaine-induced ECG changes from those induced by methylphenidate (MPH) and exercise. Methods: Subjects: Five experienced cocaine users (4 male/1 female; 41±8 years; lifetime cocaine use =17±9 years). Procedures: Subjects wore the Zephyr BioHarness 3 chest band (left mid-axillary line) during 180min of self-regulated IV cocaine administration (8, 16, and 32mg/70kg), for 90min after a single 45mg dose of oral MPH, and during 15–30min of aerobic exercise (ping pong or stationary bike) on an inpatient research unit. Statistical Analyses: 1. A computational pipeline was used to preprocess ECG data and identify ECG (P, Q, R, S and T) peaks. We extracted two types of features: one, PQRSTwaves (waveform features); two, all morphological (AM) features (PR, QRS, QT and QTc intervals), following which a binary classification model (logistic regression) was assessed for its ability to distinguish between conditions (cocaine vs. MPH; cocaine vs. exercise). Classifier performance was expressed as Area Under Receiver Operating Characteristics curve (AUROC). Results: Classifiers consistently distinguished cocaine use from exercise (N=5) andMPH(N=4)withmeanAUROCof >0.9 and>0.95 for AM and waveforms, respectively. Conclusions: If sensitivity/specificity of RWSN/ECG approach (>90%) is confirmed in larger outpatient cohorts, suchmethodsmay be of value in medication development efforts (i.e., clinical trials) for cocaine. Financial support: Supported by R01 DA03373301 and CTSA Grant Number UL1 RR024139. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.037 Comparison of synthetic substances: Diffusion of innovation framework Cynthia L. Arfken1, Cheryl Madeja1, Darlene Owens2 1 Wayne State University, Detroit, MI, United States 2 Southeast Michigan Community Alliance, Taylor,

Hookah use among college students: Prevalence, mental health and drug use

Hookah use among college students: Prevalence, mental health and drug use

Significantly lower prevalence of psychopathology in Asian compared to non-Asian methadone maintained patients

Significantly lower prevalence of psychopathology in Asian compared to non-Asian methadone maintained patients

Marijuana use among low-income urban youth: A systematic review

s / Drug and Alcohol Dependence 146 (2015) e118–e201 e149 cocaineand MA-induced reinstatement. Further, PG01037 was effective in reallocating choice behavior from cocaine to food responding in 2 of 4 monkeys. Conclusions: These data support a potential use for buspirone in the drug abuse treatment of relapse and support the continued examination of D3 compounds for novel therapeutic agents. Financial Support: DA012460, NIDA-IRP. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.321 Marijuana use among low-income urban youth: A systematic review Renee M. Johnson1, C. Kaczmarsky2, K.A. Power2 1 Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 2 Community Health Sciences, Boston University School of Public Health, Boston, MA, United States Aims: To assess whether adolescents in low-income, urban areas are less likely to use marijuana as compared to the general population of adolescents. Methods: We systematically reviewed articles from 1997 to 2012, that focused onUS youth aged 12–18 in urban areas. Samples of youth who were incarcerated, in substance abuse treatment, or homeless were excluded. Results:We identified 39 unique articles that met review criteria. Just 10.3% of the articles focused specifically on marijuana use, whereas 51.3% considered marijuana along with other substances. The final 38.5% reported marijuana use prevalence, though marijuana was not a major focus of the study. More than half (53.8%) of the studies conducted analysis using cross-sectional data, 41% used longitudinal data, and 2% used other methods or a combination of both cross-sectional and longitudinal data. Methods researchers used to assess marijuana use varied greatly. Of the 39 articles identified, 14 studies requested adolescents to report past 30-day marijuana use. Researchers recruited the majority of the participants in the selected studies in school settings (53.8%) andprimarily included racial and ethnic minorities. Clinical based urban samples tended to report higher use of marijuana than school based samples, but this was not consistent or could not be comparatively determined due to variation in data collection methods. Conclusions: Overall, populations of urban adolescents report marijuana use at levels similar to the general population. There is still much to be understood about marijuana prevalence among urban adolescents; contextual geographical and community differences may impact marijuana prevalence more than other indicators. Financial Support: The content is the sole responsibility of the authors and does not necessarily represent the official views of the NIH. Support for this publication was provided by a grant to Dr. Renee M. Johnson from the National Institute on Drug Abuse (K01DA031738). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.322 Effects of training and implementation experience on clinical skills involved in delivering Contingency Management Brinn E. Jones, Bryan Hartzler Alcohol & Drug Abuse Institute, University of Washington, Seattle, WA, United States Aims: Contingency Management (CM) is efficacious in addiction treatment and requires clinicians to perform a variety of skills during client contacts. While there is data to suggest that training improves overall CM delivery skills, little is known about how trainingmaydifferentially impact specific skill areas, andwhat skill areas merit greater emphasis in training. This study reports the effects of training and 90 days of CM implementation experience on the delivery skills of clinicians working at a community based opiate treatment program. Methods: Staff (N=16) participated in a 16-hour trainingworkshop, dispersed as four weekly half-day sessions at their clinic, and completed standardized patient (SP) intervention assessments one week prior, oneweek following training, and at a follow-up assessment after a 90-day period of trial implementation. Two sets of repeated-measures analysis of variance (RM-ANOVA) were conducted. The first, focused on immediate training impacts, assessed temporal change in CM skill areas from preto post-training. The second, focused on eventual impact of training and implementation experience, assessed temporal change from pre-training to follow-up. Given the sample size, corresponding sets of Cohen’s D for dependent measures were also computed. Results: Across individual skill areas, RM-ANOVA were statistically significant (p< .01). All of the immediate training effects were robust (d= .76–2.49), as were eventual effects of training + implementation (d= .89–2.63). Interestingly, eventual effect sizes were greater for 4 of the 6 skill areas, suggesting additive effects of training and implementation experience. Conclusions: Findings indicate robust, durable effects of training on CM delivery that are evident at the 90-day follow-up. Furthermore, it appears that the clinicians had greater improvement of CM delivery at follow-up indicating the potential that experience aided in clinician’s ability to deliver CM. However, this was not uniform over all skill areas. Financial Support: K23 DA025678. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.323 Adolescent attachment and substance use: Concurrent and prospective links Jason D. Jones, Nadia Bounoua, Lauren Pandes-Carter, C.W. Lejuez, Jude Cassidy University of Maryland, College Park, College Park,

Dependence on amphetamines increases Parkinson's disease: Effect of gender

Dependence on amphetamines increases Parkinson's disease: Effect of gender