Three-Year Outcomes After Brief Treatment of Substance Use and Mood Symptoms

Abstract Background Brief treatment (BT) can be an effective, short-term, and low-cost treatment option for many people who misuse alcohol and drugs. However, inconsistent implementation is suggested to result in BT that often looks and potentially costs similar to regular outpatient care. Prior research is also rife with inconsistent operationalizations regarding the measurement of BT received by patients. As such, there is a need to more explicitly identify and document variations in BT practice. Methods A qualitative investigation of BT in four Federally Qualified Health Centers (FQHC) was undertaken as a sub study of a larger clinical trial. Researchers interviewed 12 staff (administrators and clinicians) involved in BT oversight, referral, or delivery within the four FQHCs. Data were analyzed following an inductive approach guided by the primary research questions. Results Findings demonstrate considerable differences in how BT was conceptualized and implemented within the FQHCs. This included a variety of ways in which BT was presented and described to patients that likely impacts how they perceive the BT they receive, including potentially not understanding they received substance use disorder treatment at all. Conclusions The findings raise questions regarding the validity of prior research, demonstrating more objective definitions of BT and fidelity checklists are needed to ensure integrity of results. Future work in this area should seek to understand BT as practiced among a larger sample of providers and the direct experiences and perspectives of patients. There is also a need for more consistent implementation, quality assurance guidelines, and standardized stage of change assessments to aid practitioners.

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Youth in a pandemic: a longitudinal examination of youth mental health and substance use concerns during COVID-19

BMJ Open ◽

10.1136/bmjopen-2021-049209 ◽

2021 ◽

Vol 11 (10) ◽

pp. e049209

Author(s):

Lisa D Hawke ◽

Peter Szatmari ◽

Kristin Cleverley ◽

Darren Courtney ◽

Amy Cheung ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Longitudinal Data ◽

Young Women ◽

Latent Class ◽

Youth Mental Health ◽

Health Concerns ◽

Response Strategies ◽

Mood Symptoms ◽

Mental Health Concerns

ObjectiveThis study analyses longitudinal data to understand how youth mental health and substance use are evolving over the course of the COVID-19 pandemic, which is critical to adjusting mental health response strategies.SettingParticipants were recruited from among existing participants in studies conducted in an urban academic hospital in Ontario, Canada.ParticipantsA total of 619 youth aged 14–28 years participated in the study (62.7% girls/young women; 61.4% Caucasian).MeasuresData on mood, substance use and COVID-19-related worries were collected over four time points, that is, every 2 months beginning in the early stages of the pandemic in April 2020. Latent class analyses were conducted on the longitudinal data to identify distinct groups of youth who have different trajectory profiles of pandemic impact on their mood, substance use and COVID-19-related worries.ResultsFor the majority of participants, mood concerns increased early in the pandemic, declined over Canada’s summer months and subsequently increased in autumn. Among the youth with the highest level of mood symptoms at the beginning of the pandemic, increases in mental health concerns were sustained. Substance use remained relatively stable over the course of the pandemic. COVID-19-related worries, however, followed a trajectory similar to that of mood symptoms. Girls/young women, youth living in urban or suburban areas, in larger households, and with poorer baseline mental and physical health are the most vulnerable to mental health concerns and worries during the pandemic.ConclusionsYouth mental health symptom levels and concerns are evolving over the course of the COVID-19 pandemic, in line with the evolution of the pandemic itself, and longitudinal monitoring is therefore required. It is also essential that we engage directly with youth to cocreate pandemic response strategies and mental health service adaptations to best meet the needs of young people.

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The relative impact of brief treatment versus brief intervention in primary health-care screening programs for substance use disorders

Addiction ◽

10.1111/add.13653 ◽

2017 ◽

Vol 112 ◽

pp. 54-64 ◽

Cited By ~ 15

Author(s):

Arnie Aldridge ◽

William Dowd ◽

Jeremy Bray

Keyword(s):

Health Care ◽

Substance Use ◽

Primary Health Care ◽

Substance Use Disorders ◽

Brief Intervention ◽

Relative Impact ◽

Brief Treatment ◽

Screening Programs ◽

Primary Health

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Mood Symptoms and Impairment Due to Substance Use: A Network Perspective on Comorbidity

10.31234/osf.io/fmju2 ◽

2020 ◽

Author(s):

Daniel Moriarity ◽

Payton J. Jones

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Network Models ◽

The Other ◽

Self Report ◽

Mood Symptoms ◽

Problematic Substance Use ◽

Bidirectional Relationship ◽

Problematic Substance ◽

Future Risk

Background: Mood disorders and problematic substance use are highly comorbid and confer reciprocal risk for each other. Despite theories that posit that specific features of one disorder pose risk for the other, there is a dearth of studies utilizing complementary analytic approaches, such as network analysis. Methods: A sample of 445 participants (59.8% female, Mage = 20.3 years) completed measures of depression and hypo/mania symptoms and substance use-related impairment. Results: Impulsive and interpersonal impairment were the domains of impairment most highly co-occurring with mood symptoms. Suicidal ideation, sadness, decreased need for sleep, and guilt were the mood symptoms most highly co-occurring with substance use-related impairment. Cross-lagged panel network models found that interpersonal impairment due to substance use was the strongest cross-construct predictor of mood symptoms and that suicidal ideation and guilt were the mood symptoms most predictive of substance-related impairment. Social, intrapersonal, and physical impairment due to substance use were the domains most predicted by previous mood symptoms and decreased need for sleep, guilt, and euphoria were the most strongly predicted by past substance use-related impairment. Limitations: Measures do not assess all mood symptoms, participants with low reward sensitivity were excluded, self-report measures, some variables were single-items. Conclusions: Results suggest that components of these syndromes that confer future risk for the other might not be the same components that are predicted by the other, highlighting that the bidirectional relationship between mood symptoms and problematic substance use might be better conceptualized at the element, rather than diagnostic, level.

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