Contingency management for smoking cessation among individuals with substance use disorders: In-treatment and post-treatment effects

Abstract Introduction Previous studies have shown that sleep problems are commonly reported during treatment for substance use disorders (SUDs) and sleep complaints have been linked to subsequent relapse. However, most of these findings were in well-controlled clinical trials and may not generalize to the public. Little is known about the natural progression of sleep complaints during treatment in community clinics, the most common treatment approach for SUDs. The aim of this study is to longitudinally assess prevalence of clinically significant sleep disturbance at baseline and post-treatment in a community-based intensive outpatient (IOP) SUD treatment program using a multi-method approach with well-validated measures of sleep. Methods Adults beginning IOP SUD treatment completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Nightmare Disorder index (NDI), and one week of actigraphy and sleep diaries. Measures were repeated following treatment (approximately 5 weeks later). Results Preliminary analyses on 21 adults who have been enrolled thus far revealed 85.6% of participants experienced sleep disturbance (PSQI > 5) at baseline. 28.5% of participants reached cutoff for moderate-to-severe insomnia symptoms (ISI > 15) and 42.9% reported nightmares more than once per week. Sleep parameters taken from actigraphy and sleep diaries revealed mean sleep efficiency was 77.5% (TST M = 6.2 hours; TIB M = 7.9 hours). These variables did not improve from baseline to post-treatment. Further, most measures indicated a worsening of sleep, though this did not reach significance (all ps > .05). Conclusion This preliminary data show a high prevalence of self-reported sleep complaints and objectively measured poor sleep efficiency that do not improve over the course of treatment. Data collection is ongoing and expected to at least double. More robust analyses, including differences between SUD type (e.g., cannabis vs. opioid) and relationship to relapse at post-treatment, will then be completed. Support K12DA031794

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Contingency Management for the Treatment of Substance Use Disorders

10.1007/978-3-030-75961-2_7 ◽

2021 ◽

pp. 77-88

Author(s):

Viviane Simões ◽

Rodolfo Yamauchi ◽

André Q. C. Miguel

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Contingency Management

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Non-Pharmacological Therapies for Substance Use Disorders (DRAFT)

10.1093/med/9780190265366.003.0020 ◽

2018 ◽

Author(s):

Michael F. Weaver

Keyword(s):

Primary Care ◽

Substance Use ◽

Substance Use Disorders ◽

Behavioral Therapy ◽

Contingency Management ◽

Motivational Enhancement Therapy ◽

Present Level ◽

Duration Of Treatment ◽

Motivational Enhancement ◽

Level Of Understanding

In conjunction with chapters 16 and 17, which described non-pharmacological approaches to pain management, this chapter reviews the available non-pharmacological approaches to substance use disorders (SUD). Specific subtopics include 12-Step programs and facilitation, motivational enhancement therapy, cognitive behavioral therapy, individual and group psychotherapies, contingency management, community reinforcement, family therapy, relapse management, and the terminal consideration of all therapies, termination (what is the duration of treatment)? Each subtopic is addressed in abstract rather than in comprehensive format, to allow the primary care provider to identify her level of interest and present level of understanding, and to inform further reading. The chapter concludes with a text box providing additional resources.

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Psychosocial Treatment Approaches for Substance Use

10.1093/med/9780190275334.003.0013 ◽

2018 ◽

Author(s):

Lynn McFarr ◽

Julie Snyder ◽

Lisa Benson ◽

Rachel Higier

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Meta Analysis ◽

Contingency Management ◽

Psychosocial Interventions ◽

Psychosocial Treatment ◽

Community Based ◽

Theoretical Orientations ◽

Psychosocial Treatments ◽

Community Based Programs

Multiple psychosocial treatments for substance-use disorders have been studied for efficacy. A recent meta-analysis indicates that psychosocial interventions are effective across multiple types of substances used. In the case of opiates, psychosocial interventions combined with medication appear to be the most effective. Many studies further agree that psychosocial interventions are an integral and necessary part of treating substance-use disorders. Although theoretical orientations may differ across psychosocial treatments, they have several principles and practices in common. All involve talk therapy or talk in communities as a way to clarify triggers, build commitment, and improve accountability. Many also target addiction behaviors and work to develop alternative contingencies to reduce or eliminate use. Finally, targeting repeated performance (or building “chains of committed behavior”) decreases the likelihood of relapse. This chapter discusses the most frequently studied and employed psychosocial treatments for substance use including CBT, motivational interviewing, contingency management, mindfulness, and community-based programs.

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Psychosocial Treatments for Substance Use Disorders

10.1093/med:psych/9780199342211.003.0023 ◽

2015 ◽

Cited By ~ 2

Author(s):

Daniel M. Blonigen ◽

John W. Finney ◽

Paula L. Wilbourne ◽

Rudolf H. Moos

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Substance Use Disorders ◽

Behavioral Interventions ◽

Contingency Management ◽

Limited Evidence ◽

Motivational Enhancement ◽

Differential Effectiveness ◽

Cognitive Behavioral Interventions ◽

Use Behavior

The most effective psychosocial modalities for treating substance use disorders are cognitive-behavioral interventions, motivational interviewing and motivational enhancement, contingency management, community reinforcement, behavioral couples and family therapies, and 12-step facilitation approaches. The foci of these interventions include substance use behavior, patients’ life contexts, and their social and personal resources. Limited evidence is available for these interventions’ differential effectiveness. Brief interventions are highly effective in the treatment of alcohol use disorders. However, as stand-alone treatments, they are best suited for individuals with mild to moderate alcohol use problems. Therapists who are interpersonally skilled, empathic, and nonconfrontational, and who develop a strong therapeutic alliance, are more effective at helping patients achieve better outcomes.

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