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Of Note

December 1, 2006
by root
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Programs See More Evidence of Benefits From Incentives

The research evidence is mounting that addiction treatment programs can see benefits from offering certain clients incentives for maintaining sobriety (see September/October 2006 issue). A study supported by the National Institute on Drug Abuse (NIDA) suggests that offering methamphetamine abusers both psychosocial therapy and a contingency management system of rewards for clean urine screens results in more effective outcomes than what is seen from psychosocial therapy alone. Clients in clinics that participated in this 12-week study received rewards of plastic chips that could be redeemed for various prizes. Study results were published in the November issue of the American Journal of Psychiatry.

“This study represents the first controlled trial of [contingency management] in the treatment of methamphetamine abuse,” NIDA Director Nora D. Volkow, MD, said in a statement. Researchers led by John Roll of Washington State University found that clients receiving rewards maintained continuous abstinence for an average of nearly five weeks, compared to an average of fewer than three weeks of abstinence in the therapy-only group. Therapy used at the participating clinics consisted of either comprehensive psychosocial treatment under the Matrix Model or a combination of cognitive-behavioral therapy and relapse prevention strategies.

DUI Clients' Problems Could Transcend Alcohol

Substance abuse treatment programs that see a good number of clients who have been arrested for driving under the influence may want to consider the presence of co-occurring mental health problems in these individuals. A study conducted by Sandra Lapham, MD, MPH, director of the PIRE Behavioral Health Research Center of the Southwest in Albuquerque, New Mexico, found that in a group of people convicted of at least two DUI offenses in the past 10 years, nearly 60% reported experiencing major depression, bipolar disorder, obsessive-compulsive disorder, or post-traumatic stress disorder (PTSD) over their lifetime. Depression rates were higher among women in the study, while PTSD was more common in the men studied.

“The offender should be viewed as a unique person with a unique set of issues,” Lapham said. “If they include psychiatric problems, these should be treated along with drug and alcohol issues.” Study participants were part of a three-year judicial program in Multnomah County, Oregon, in which DUI offenders can receive reduced jail time in exchange for intensive supervision under a system of rewards and punishments. Study results were published in the September issue of the Journal of Studies on Alcohol.

Meth, Prescription Rx Admissions Continue to Gain in Prominence

Statistics released earlier this year from the Treatment Episode Data Set (TEDS) for 2004 indicate that substance abuse treatment admissions for methamphetamine and prescription pain medications have continued to increase in recent years. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported that methamphetamine admissions to treatment increased by 25% from 2002 to 2004, and admissions for opiates other than heroin rose by 42% over the same period. The federal data show 129,179 treatment admissions for which methamphetamine was the primary substance of abuse in 2004, and 63,243 admissions that year for which prescription opiates were the primary drug of abuse.

The 2004 data showed that in seven states, at least 20% of substance abuse treatment admissions were a result of methamphetamine abuse. Those states are Arkansas, California, Hawaii, Idaho, Nevada, Oklahoma, and Utah. The TEDS report is based on 1.8 million annual admissions to facilities licensed or certified by each state's substance abuse agency.