ADAI News

New Reports from ADAI Review Treatment & Policy Issues in Washington State

Three recent reports by the Alcohol & Drug Abuse Institute at the University of Washington address current issues of interest to treatment providers and policy makers in Washington State.  The reports were developed for the WA State Health Care Authority, Division of Behavioral Research (DBHR).

Evidence-based Practices in Washington State. Susan Stoner, UW Alcohol & Drug Abuse Institute, September 2018, 63p.  

In law and practice, Washington State has long promoted the use of evidence-based practices in the treatment of substance use disorders and mental health; Washington is recognized as a national leader in evidence-based policy-making.

This report reviews Washington's experience advancing evidence-based practices in mental health and substance use treatment. It presents a brief history of the evidence-based practices movement; touches on how the movement has affected policy-making; describes how policies have been translated into procedures in treatment for children and youth; contextualizes and characterizes where things stand with policies and procedures in the treatment of adults and substance use disorders; identifies key partners in the efforts to advance evidence-based practices in Washington; presents findings from a statewide survey about evidence-based practices; and offers some basic recommendations for the future of EBP.

The Role of Medications in the Treatment of Adolescents and Young Adults with OUD. Caleb Banta-Green and Laura Cooley.  UW Alcohol & Drug Abuse Institute, November 2018, 28p.

Diagnoses of opioid use disorder (OUD) among adolescents and young adults have increased substantially in the U.S. over the past 15 years. The use of treatment medications for opioid use disorder has also increased, though recent estimates show that only one in four young adults diagnosed with OUD have received any treatment medications.

The medications buprenorphine and methadone have strong evidence demonstrating their effectiveness; they are considered front-line treatment for opioid use disorder and are recommended by the American Academy of Pediatrics.  This report details the current evidence base for OUD treatment medications, along with expert guidance for prescribers and treatment providers on the use of these medications and supportive services.

Methamphetamine in Washington. Susan Stoner, Jason Williams, Alison Newman, Nancy Sutherland, and Caleb Banta-Green. UW Alcohol & Drug June 2018, 35p. Appendices A-E  

Methamphetamine use is a significant and increasing problem in Washington State. This report presents the scope of methamphetamine use; reviews harms associated with use; describes characteristics of users, their treatment utilization and needs; and reviews current approaches for treating methamphetamine use disorder. Finally, it notes key issues to consider when developing strategies aimed at reducing the use of and harms associated with methamphetamine use in Washington.  The report is informed by participants of a March 2018 meeting of the DBHR/ADAI Treatment Research Subcommittee, which focused on issues around methamphetamine use.

You can find more publications from ADAI on our website: http://adai.uw.edu/pubs/

 

Latest Research Publications from ADAI Staff

Publishing articles in peer-reviewed, scientific journals is a key part of the research and and dissemination activities of the Alcohol & Drug Abuse Institute. 

Here are some of the recent articles from ADAI researchers:

• Garrett SB, Doyle SR, Peavy MK, Wells EA, Owens MD, Shores-Wilson K, DiCenzo J, Donovan DM. Age differences in outcomes among patients in the “Stimulant Abuser Groups to Engage in 12-Step” (STAGE-12) intervention. Journal of Substance Abuse Treatment 2018;84:21-29. doi: 10.1016/j.jsat.2017.10.012.
  
  
• Kling CE, Perkins JD, Carithers RL, Donovan DM, Sibulesky L. Recent trends in liver transplantation for alcoholic liver disease in the United States. World Journal of  Hepatology 2017;9(36):1315-1321. doi: 10.4254/wjh.v9.i36.1315.
  
  
• Peavy KM, Garrett S, Doyle SR, Donovan DM. A comparison of African American and Caucasian stimulant users in 12-step facilitation treatment. Journal of Ethnicity and Substance Abuse 2017;16(3):380-399. doi: 10.1080/15332640.2016.1185657.
  
  
• Grant TM, Graham C, Carlini BH, Ernst CC, Brown NN. Use of marijuana and other substances among pregnant and parenting women with substance use disorders: changes in Washington State after marijuana legalization. Journal of Studies on Alcohol & Drugs 2018;79(1):88-95. doi: 10.15288/jsad.2018.79.88.
  
  
• Banta-Green CJ, Coffin PO, Merrill JO, Sears JM, Dunn C, Floyd AS, Whiteside LK, Yanez ND, Donovan DM. Impacts of an opioid overdose prevention intervention delivered subsequent to acute care. Injury Prevention 2018 (in press). doi: 10.1136/injuryprev-2017-042676.
  
  
• Glick SN, Burt R, Kummer K, Tinsley J, Banta-Green CJ, Goldena MR. Increasing methamphetamine injection among non-MSM who inject drugs in King County, Washington. Drug & Alcohol Dependence 2018;182:86–92. doi: 10.1016/j.drugalcdep.2017.10.011.

Parent-Child Assistance Program (PCAP): Implementation Manual Published

The Parent-Child Assistance Program (PCAP) is an an intensive, in-home intervention to help mothers who abuse alcohol or drugs during pregnancy. Its goals are to help mothers build healthy families and prevent future births of children exposed prenatally to alcohol and drugs. 

PCAP began in 1991 at the University of Washington as a federally-funded research demonstration of an intensive, 3-year advocacy/case management model with high-risk mothers and their children.  The intervention has an extensive evidence base, with independent documentation of cost-savings.  Based on this record of success, the Washington State Legislature subsequently funded PCAP to develop sites throughout Washington state and the model has been replicated at dozens of other sites in the U.S. and Canada. 

In 2017, UW professor and PCAP developer Therese M. Grant, PhD and colleagues created a detailed manual to assist agencies who want to bring PCAP to their communities and agencies.  The manual describes the steps to implement the intervention, from start-up and enrolling clients, delivering the intervention, special considerations, and evaluation.   

For more information, please visit the PCAP website or contact PCAP staff at the UW or in one of the PCAP community agencies in Washington.

Download the manual: Parent-Child Assistance Program (PCAP). A Model of Effective Case Management Intervention with High-Risk Families / by Therese M. Grant et al, Fetal Alcohol & Drug Unit, University of Washington, Seattle, July 2017.

SUD in HIV Care: Prevalence, Impact on Retention, and Risk for Developing Cannabis Use Disorders

A series of articles by ADAI scientist Bryan Hartzler and colleagues analyzes substance use disorders among patients in HIV care, including SUD prevalence, its impact on care retention, and identifying those at risk for developing cannabis use disorders. 

The studies used data from the CFAR Network of Integrated Cohort Studies (CNICS), the first electronic medical records-based network to integrate clinical data from a large and diverse population (32,727 patients) of HIV-infected persons in the modern HAART era.

1. Hartzler B, Dombrowski JC, Crane HM, Eron JJ, Geng EH, Christopher Mathews W, Mayer KH, Moore RD, Mugavero MJ, Napravnik S, Rodriguez B, Donovan DM. Prevalence and Predictors of Substance Use Disorders Among HIV Care Enrollees in the United States. AIDS and Behavior 2017 Apr;21(4):1138-1148
   
   
2. Hartzler B, Dombrowski JC, Williams JR, Crane HM, Eron JJ, Geng EH, Mathews C, Mayer KH, Moore RD, Mugavero MJ, Napravnik S, Rodriguez B, Donovan DM. Influence of Substance Use Disorders on 2-Year HIV Care Retention in the United States. AIDS and Behavior 2017 (in press)
   
   
3. Hartzler B, Carlini BH, Newville H, Crane HM, Eron JJ, Geng EH, Mathews WC, Mayer KH, Moore RD, Mugavero MJ, Napravnik S, Rodriguez B, Donovan DM. Identifying HIV care enrollees at-risk for cannabis use disorder. AIDS Care 2017;29(7):846-850.

Recent Brief Reports from ADAI

Results of ADAI research are published in articles in peer-reviewed journals and presented at scientific conferences.  We also produce brief reports and summaries on a variety of topics, aimed at the wider audience of providers, policy makers, and the public.  These reports are supported by diverse funding sources.   

Funder: WA State Div. of Behavioral Health & Recovery (DBHR):

• Practical and Ethical Considerations in Providing Parent-Initiated Residential Treatment to Youth. Reviews relevant literature for group care for children and adolescents, residential treament for youth, and secure residential treatment in a juvenile justice context. No studies found on issues regarding absconding / elopment in SUD and COD facilities for youth vs. maintaining a therapeutic environment.
• Locked vs. Unlocked Facilities for Treating Youth with Substance Use Disorder.  Residential treatment facilities are frequently sought for adolescents with severe substance use and/or behavior disorders, yet it remains hotly debated whether residential care is superior to community-based care. Among residential treatment facilities, there is a question of whether locked or unlocked (i.e., secure or non-secure) units are better in terms of benefits or outcomes. This brief reviews the literature on this topic.
• Medication Safety: Online Resources. Annotated list of educational resources and materials on medication safety for various classes of drugs; describes audience, message, sponsor, and more.

Funder: I-502 for research on marijuana:

• Cannabis Use Disorder
• Screening and Assessment Tools for Cannabis Use Disorders
• Marijuana's Impact on Pregnant Women and their Children
• Vaping Marijuana

Funder: ADAI and other sources:

• Fentanyl Death Investigation in Four Washington State Counties.  Overdose deaths from fentanyl and fentanyl-analog drugs are increasing in the U.S. and elsewhere. This analysis focuses on the type of fentanyl substance, the possible source, the form/appearance, and how it was used. Findings will be used to inform public health educational messaging and possible improvements to death investigation procedures.

Heroin’s Imprint Deepens in King County, Report Shows

In UW NewsBeat, Brian Donohue reports that heroin overdoses claimed the lives of 132 people in King County in 2015, and treatment admissions involving that drug surpassed those of alcohol for the first time, according to an annual report published today by the University of Washington’s Alcohol and Drug Abuse Institute.

In compiling data from multiple public agencies, the Drug Use Trends report (download PDF) reflects 2015 usage trends of multiple drug types and the effects – requests for information and referrals, treatment admissions, police evidence tests, etc. – experienced by drug users and the broader community. 

“Drug deaths and substance-use disorders continue to have a serious impact across King County," said Caleb Banta-Green, senior research scientist and the report’s lead author. “At the same time, important interventions including substance-use disorder treatment, clean-syringe distribution, and use of the opioid overdose antidote, naloxone, are all increasing.”

Key findings:

• Heroin has been the most common drug identified in overdose deaths for the past two years. Half of young adults 18 to 29 years of age entering treatment for the first time for heroin report smoking and half report injecting heroin, a substantial increase in smoking compared to 2009. Total drug treatment admissions for heroin surpassed alcohol for the first time in 2015.
• Pharmaceutical opioid problem indicators have declined somewhat, but remain high.
• Illicitly manufactured, synthetic opioids, such as acetyl fentanyl have begun to be detected in some deaths as well as in police evidence reports.
• Methamphetamine problem indicators persist and recently users have begun combining methamphetamine with heroin and this combination in deaths has increased substantially.
• Cocaine persists as a drug of abuse associated with morbidity and mortality with modest declines in recent years.  Injectors’ use of cocaine and heroin together has declined as use of methamphetamine and heroin together have increased
• Marijuana treatment admissions have declined.

Read the full story in UW NewsBeat . . .

Marijuana: New Articles, Reports, and Resources from ADAI

• Marijuana Use by Older Adults. SA Stoner (6/2016)  As acceptance of cannabis use is on the increase across the country, it's important to consider the implications for the fastest growing segment of the population, older adults.  Read...
  
• Marijuana Use Survey Matrix. J Williams & C Banta-Green  (4/2016) Compares methodology and features of major state and national drug use surveys of marijuana use for both youth and adults.  Read...
  
• Cannabis Use among Drivers Suspected of Driving Under the Influence or Involved in Collisions: Analysis of Washington State Patrol Data. C Banta-Green, A Rowhani-Rahbar, B Ebel, LM Andris, and Q Qui.  (6/2016)  Examines drivers involved in collisions and/or arrested for suspected driving under the influence (DUI), documenting the trends in THC involvement over time and in relation to the legalization of cannabis; the prevalence of THC alone and in combination with other potentially intoxicating drugs; the estimated time to blood draw under real world conditions; and the relationship between estimated time to blood draw and the level of THC detected. Read...

New Articles, Chapters, & Reports from ADAI

Client evaluation of treatment for alcohol use disorder in COMBINE. Kirouac, Witkiewitz, and Donovan. J Subst Abuse Treatment 2016, 67:38-43.

The Evaluation of Treatment measure can be used to assess client treatment satisfaction in alcohol use disorder treatment along one higher order dimension, representing overall evaluation of treatment, and six lower order dimensions, representing general satisfaction, urges, therapist, skills, self, and mutual help engagement.  More...

Treating youth substance use: EBPs & their Clinical significance.  SA Stoner. ADAI Brief Report (3/2016)

Summary of the ADAI project to review and rate substance use treatments for youth, with brief description of treatments rated as "evidence-based pratices."   Read...

Differences in tobacco product use among past-month adult marijuana users and nonusers: findings From the 2003-2012 National Survey on Drug Use and Health. Schauer, Berg, Kegler, Donovan, and Windle.  Nicotine Tob Res 2016, 18(3):281-8.

This study assessed differences in individual tobacco product use between past month marijuana users and nonusers, and trends in overall tobacco use and use of specific tobacco products among marijuana users. More...

A comparison of African American and Caucasian stimulant users in 12-step facilitation treatment.  Peavy, Garrett, Doyle, and Donovan. J Ethnicity Subst Abuse 2016 (in press)

Engagement in 12-step meetings and activities has been shown to be a powerful aid to recovery from substance use disorders. However, only limited attention has been given to ethnic and racial differences in attitudes toward 12-step and involvement.   More...