CTN-0044 Outcomes: Internet-Based Substance Abuse Treatment Improves Access and Outcomes

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computerguyThis article, currently in-press at American Journal of Psychiatry and written by Aimee Campbell, Edward Nunes, Abigail Matthews, and colleagues, reports on the primary outcomes of National Drug Abuse Treatment Clinical Trials Network protocol CTN-0044, “Web Delivery of Evidence-Based, Psychosocial Treatment for Substance Use Disorders.”

Evergreen Manor of the Pacific Northwest Node was one of the CTPs involved in this study.

Computer-delivered intervention have the potential to improve access to quality addiction treatment care. This study evaluated the effectiveness of the Therapeutic Education System (TES), an Internet-based behavioral intervention that includes motivational incentives, as a clinician-extender in the treatment of substance use disorders.

Adult men and women (N=507) entering 10 outpatient addiction treatment programs were randomly assigned to receive 12 weeks of either treatment as usual (TAU) (N=252) or TAU plus TES, with the intervention substituting for about 2 hours of standard care per week (N=255).

TES consists of 62 computerized interactive modules covering skills for achieving and maintaining abstinence, plus prize-based motivational incentives contingent on abstinence and treatment adherence. Treatment as usual consisted of individual and group counseling at participating programs.

Compared with patients in the TAU group, those in the TES group had a lower dropout rate and a greater abstinence rate (as measured by twice-weekly urine drug screens and self-report). This effect was more pronounced among patients who had a positive urine drug or breath alcohol screen at study entry.

Conclusions: Internet-delivered interventions such as TES have the potential to help bridge the gap between the enormous need for high-quality evidence-based treatment for addiction and the capacity of the treatment system to deliver. Additional research is needed to assess the long-term effectiveness of TES, as well as its effectiveness in non-specialty clinical settings, including primary care.

Citation: Campbell ANC, Nunes EV, Matthews AG, et al. Internet-Delivered Treatment for Substance Abuse: A Multisite Randomized Controlled Trial. American Journal of Psychiatry 2014 (in press).


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