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Brief online interventions targeting risk and protective factors for increased and problematic alcohol use among American college students studying abroad
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Abstracts / Drug and Alcohol Dependence 140 (2014) e169–e251
for Persistent Occasional Users only (OR 1.7, 95%CI 1.1–2.8). Differences for marijuana trajectories were similar, but less pronounced (30%, 25%, 24%, 20% and 13% for Persistent, Decreasing, Increasing, Occasional and Non-users, respectively, p < .001). The lack of PC was more common for the Increasing marijuana trajectory group (OR 1.7, 95% CI 1.0–2.7) after adjustment. Conclusions: Among adults in the general population, 4 in 10 persistent non-marijuana drug users and 3 in 10 marijuana users lacked primary care in middle age. The unsettled question of whether to screen for drug use in primary care should include consideration of who might be missed. Financial support: NIDA R01-DA-025067; NHLBI N01-HC95095; N01-HC-48047. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.482 Brief online interventions targeting risk and protective factors for increased and problematic alcohol use among American college students studying abroad Eric R. Pedersen 1 , M.E. Larimer 2 , D. Atkins 2 , C. Lee 2 , C. Neighbors 3 1
RAND Corporation, Santa Monica, CA, United States University of Washington, Seattle, WA, United States 3 University of Houston, Houston, TX, United States 2
Aims: Research documents increased and problematic alcohol use during American student study abroad experiences. Despite increasing numbers of students studying abroad each year and a growing concern about this high-risk event, there is no research available documenting efficacious preventive programs for these students. Previous work suggests perceptions of study abroad peer drinking and host country native adult drinking are risk factors for increased alcohol use while abroad, while components related to positive Sojourner Adjustment (i.e., healthy temporary cultural adjustment) may protect against problematic use. Methods: Employing a 2 × 2 longitudinal randomized controlled intervention design, the present study sought to prevent increased and problematic alcohol use by correcting misperceptions of peer norms and by promoting positive and healthy adjustment into the host culture through brief online personalized feedback interventions. A sample of 343 study abroad students were randomly assigned to one of four conditions including a personalized normative feedback intervention (PNF), a Sojourner Adjustment feedback intervention (SAF), a combined PNF + SAF intervention, and an assessment only control condition. Results: Multilevel regression analyses revealed that, contrary to hypotheses, participants in the SAF intervention condition increased their drinking by a rate of 31% during the first month abroad compared to control. In contrast, SAF and PNF participants reported a 31% and 27% reduction, respectively, in alcohol-related consequences compared to control participants during the last month abroad. Conclusions: This research represents an important first step in designing and implementing efficacious interventions with atrisk study abroad college students using online methodologies with normative information and Sojourner Adjustment content. Financial support: 1F31AA018591 awarded to Eric Pedersen from NIAAA. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.483
Trajectory of treatment, hospitalization and relapse of crack users Rosemeri S. Pedroso, Veralice M. Gonc¸alves, L.S. Guimarães, R.L. Rosa, M. Pettenon, F.H. Kessler, F. Pechansky Center for Drug and Alcohol Research, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Aims: This study mapped the treatment trajectories of male crack users describing the attempts for hospitalization and relapse after discharge. Methods: Cross-sectional study with 207 male inpatient crack users. We used a form with demographic data and the Questionnaire for Treatment Trajectories of Crack Users. Results: In the search for hospitalization, 50% have tried up to 2 times (mean = 2.12 times) to succeed. Between the first attempt and hospitalization, 50% of the sample waited up to 3 days (mean = 6.47 days), with 92.8% of the sample admitted in public health. Crack users of this study indicated that the main factors influencing relapse after discharge from the first admission were occupational problems (65.5%) and legal problems (62.1%). In their own perception, the main factors that can influence abstinence after discharge were medication (92.3%) and ability to handle risky situations (96.6%). Of the total sample, 144 patients (69.6%) reported previous hospitalizations on an average of 2.26 times, totalizing 357 inpatient admissions. The average length of stay was 52.83 days (median = 28 [16.25; 36.75]). Out of 357 admissions, about 322 (90%) showed relapse after discharge, and half of these relapses occurred in less than 30 days (median = 30 [6, 120]), an average of 90 days between discharge from hospital and relapse using crack. Conclusions: In this study, the majority of the subjects had relapse to the use of crack less than a month after discharge, indicating the need to develop inpatient treatments suitable to prepare the crack user for abstinence in front of factors that influence relapse. Financial support: Brazilian Secretariat for Drug Policies (SENAD), project number # 10/0002. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.484 What happens when stabilized methadone-maintained dose must be changed? Einat Peles, S. Schreiber, A. Sason, M. Adelson Adelson Clinic for Drug Abuse Treatment & Research, Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Aims: Adequate methadone dose is highly important to patients’ success in Methadone Maintenance Treatment (MMT). Stable dose was found to be related to multiple factors including environmental and genetics. The individual stable methadone dose is determined by patients’ report, clinically, and laboratory results. However, through treatment, various medical reasons may lead to change the stabled methadone dose (i.e. prolonged QTc, non therapeutic level of blood methadone, etc). Our aims to follow up stabilized patients following dose change, and to evaluate whether patients can be stabilized on different methadone doses during their treatment. Methods: Inclusions were 138 patients who were clinically stabilized (steady methadone dose and no opiate, cocaine, amphetamine for at least 3 months) and their methadone blood level was checked before first take-home dose (Group 1, n = 93), or annually (Group 2, n = 45)). Group 3 were 20 stabilized patients whose dose was reduced due to QTc prolongation.
Abstracts / Drug and Alcohol Dependence 140 (2014) e169–e251
for Persistent Occasional Users only (OR 1.7, 95%CI 1.1–2.8). Differences for marijuana trajectories were similar, but less pronounced (30%, 25%, 24%, 20% and 13% for Persistent, Decreasing, Increasing, Occasional and Non-users, respectively, p < .001). The lack of PC was more common for the Increasing marijuana trajectory group (OR 1.7, 95% CI 1.0–2.7) after adjustment. Conclusions: Among adults in the general population, 4 in 10 persistent non-marijuana drug users and 3 in 10 marijuana users lacked primary care in middle age. The unsettled question of whether to screen for drug use in primary care should include consideration of who might be missed. Financial support: NIDA R01-DA-025067; NHLBI N01-HC95095; N01-HC-48047. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.482 Brief online interventions targeting risk and protective factors for increased and problematic alcohol use among American college students studying abroad Eric R. Pedersen 1 , M.E. Larimer 2 , D. Atkins 2 , C. Lee 2 , C. Neighbors 3 1
RAND Corporation, Santa Monica, CA, United States University of Washington, Seattle, WA, United States 3 University of Houston, Houston, TX, United States 2
Aims: Research documents increased and problematic alcohol use during American student study abroad experiences. Despite increasing numbers of students studying abroad each year and a growing concern about this high-risk event, there is no research available documenting efficacious preventive programs for these students. Previous work suggests perceptions of study abroad peer drinking and host country native adult drinking are risk factors for increased alcohol use while abroad, while components related to positive Sojourner Adjustment (i.e., healthy temporary cultural adjustment) may protect against problematic use. Methods: Employing a 2 × 2 longitudinal randomized controlled intervention design, the present study sought to prevent increased and problematic alcohol use by correcting misperceptions of peer norms and by promoting positive and healthy adjustment into the host culture through brief online personalized feedback interventions. A sample of 343 study abroad students were randomly assigned to one of four conditions including a personalized normative feedback intervention (PNF), a Sojourner Adjustment feedback intervention (SAF), a combined PNF + SAF intervention, and an assessment only control condition. Results: Multilevel regression analyses revealed that, contrary to hypotheses, participants in the SAF intervention condition increased their drinking by a rate of 31% during the first month abroad compared to control. In contrast, SAF and PNF participants reported a 31% and 27% reduction, respectively, in alcohol-related consequences compared to control participants during the last month abroad. Conclusions: This research represents an important first step in designing and implementing efficacious interventions with atrisk study abroad college students using online methodologies with normative information and Sojourner Adjustment content. Financial support: 1F31AA018591 awarded to Eric Pedersen from NIAAA. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.483
Trajectory of treatment, hospitalization and relapse of crack users Rosemeri S. Pedroso, Veralice M. Gonc¸alves, L.S. Guimarães, R.L. Rosa, M. Pettenon, F.H. Kessler, F. Pechansky Center for Drug and Alcohol Research, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Aims: This study mapped the treatment trajectories of male crack users describing the attempts for hospitalization and relapse after discharge. Methods: Cross-sectional study with 207 male inpatient crack users. We used a form with demographic data and the Questionnaire for Treatment Trajectories of Crack Users. Results: In the search for hospitalization, 50% have tried up to 2 times (mean = 2.12 times) to succeed. Between the first attempt and hospitalization, 50% of the sample waited up to 3 days (mean = 6.47 days), with 92.8% of the sample admitted in public health. Crack users of this study indicated that the main factors influencing relapse after discharge from the first admission were occupational problems (65.5%) and legal problems (62.1%). In their own perception, the main factors that can influence abstinence after discharge were medication (92.3%) and ability to handle risky situations (96.6%). Of the total sample, 144 patients (69.6%) reported previous hospitalizations on an average of 2.26 times, totalizing 357 inpatient admissions. The average length of stay was 52.83 days (median = 28 [16.25; 36.75]). Out of 357 admissions, about 322 (90%) showed relapse after discharge, and half of these relapses occurred in less than 30 days (median = 30 [6, 120]), an average of 90 days between discharge from hospital and relapse using crack. Conclusions: In this study, the majority of the subjects had relapse to the use of crack less than a month after discharge, indicating the need to develop inpatient treatments suitable to prepare the crack user for abstinence in front of factors that influence relapse. Financial support: Brazilian Secretariat for Drug Policies (SENAD), project number # 10/0002. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.484 What happens when stabilized methadone-maintained dose must be changed? Einat Peles, S. Schreiber, A. Sason, M. Adelson Adelson Clinic for Drug Abuse Treatment & Research, Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Aims: Adequate methadone dose is highly important to patients’ success in Methadone Maintenance Treatment (MMT). Stable dose was found to be related to multiple factors including environmental and genetics. The individual stable methadone dose is determined by patients’ report, clinically, and laboratory results. However, through treatment, various medical reasons may lead to change the stabled methadone dose (i.e. prolonged QTc, non therapeutic level of blood methadone, etc). Our aims to follow up stabilized patients following dose change, and to evaluate whether patients can be stabilized on different methadone doses during their treatment. Methods: Inclusions were 138 patients who were clinically stabilized (steady methadone dose and no opiate, cocaine, amphetamine for at least 3 months) and their methadone blood level was checked before first take-home dose (Group 1, n = 93), or annually (Group 2, n = 45)). Group 3 were 20 stabilized patients whose dose was reduced due to QTc prolongation.