Pilot Cohorts for Development of Concurrent Mobile Treatment for Alcohol and Tobacco Use Disorders.

Abstract

Alcohol and tobacco are the 2 most frequently used drugs in the United States and represent the highest co-occurrence of polysubstance use. The objective of this study was to refine an intervention combining mobile contingency management with cognitive-behavioral telephone counseling for concurrent treatment of alcohol and tobacco use disorders. Two cohorts (n = 13 total, n = 5 women) of participants were enrolled, with 10/13 completing treatment and 7/13 completing the 6-month follow-up. At enrollment, participants were drinking a mean of 28.9 drinks per week (SD = 14.1), with a mean of 14.7 heavy drinking days in the past month (SD = 9.9), and a mean of 18.1 cigarettes per day (SD = 11.7). Treatment included a mobile application that participants used to record carbon monoxide and breath alcohol content readings to bioverify abstinence. Participants received up to 4 sessions of phone cognitive-behavioral therapy and monetary reinforcement contingent on abstinence. In cohort 1, 4/6 participants reported abstinent or low-risk drinking post-monitoring. Six weeks post quit-date, 2/6 participants were CO-bioverified abstinent from tobacco use, with 2/6 in dual remission. These results were maintained at 6-months. In cohort 2, 6/7 reported abstinent or low-risk drinking post-monitoring, 5 weeks post quit-date. At the post-monitoring visit, 5/7 were CO-bioverified abstinent from smoking, with 5/7 in dual remission. At 6-months, 3/7 reporting abstinent or low-risk drinking, 1/7 had bioverified abstinence from smoking, with 1/7 in dual remission. Observations suggest that it is possible to develop a concurrent mobile treatment for alcohol and tobacco use disorders.

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Citation

Published Version (Please cite this version)

10.1177/11782218211030524

Publication Info

Medenblik, Alyssa M, Patrick S Calhoun, Stephen A Maisto, Daniel R Kivlahan, Scott D Moore, Jean C Beckham, Sarah M Wilson, Dan V Blalock, et al. (2021). Pilot Cohorts for Development of Concurrent Mobile Treatment for Alcohol and Tobacco Use Disorders. Substance abuse : research and treatment, 15. p. 11782218211030524. 10.1177/11782218211030524 Retrieved from https://hdl.handle.net/10161/23862.

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Scholars@Duke

Calhoun

Patrick Shields Calhoun

Professor in Psychiatry and Behavioral Sciences

I specialize in the assessment and treatment of the psychological and behavioral sequelae of posttraumatic stress disorder (PTSD) including the use of cognitive-behavioral interventions to reduce PTSD symptoms, aggression, and substance misuse.

 Research interests

  • The psychological, behavioral, and health consequences of traumatic stress
  • Health services research related to PTSD and associated behavioral difficulties
  • Identification of innovative health behavior change interventions to reduce smoking, alcohol, and drug misuse
  • Implementation Science
  • Psychometric assessment and methodology
Moore

Scott Daniel Moore

Professor Emeritus of Psychiatry and Behavioral Sciences

We are currently developing a model system for the investigation of physiological effects of acute ethanol. This model utilizes a rat brain slice preparation incorporating the amygdala, a brain region associated with anxiety and ethanol-induced anxiolysis. We anticipate expanding this model to investigate effects of other anxiolytic agents and to elucidate the basic mechanisms underlying anxiogenesis.

We are also currently examining the neurobiological basis of seizure-induced memory disruption using similar in vitro electrophysiological techniques. Full development of this model should provide important information relevant to basic mechanisms of memory. We anticipate expanding this model to include behavioral correlates.

Beckham

Jean Crowell Beckham

Professor in Psychiatry and Behavioral Sciences

Interest in assessment and treatment of trauma, particularly as occurs for both women and men during military service; focus in treatment outcome of differential and collective contribution for psychopharmacological and behavioral interventions in PTSD populations; long term physical health effects of chronic posttraumatic stress disorder.

Dedert

Eric Dedert

Associate Professor in Psychiatry and Behavioral Sciences

I am a Research Psychologist at the Durham VA Medical Center and Associate Professor at the Duke University Medical Center, where I conduct research with the Traumatic Stress and Health Research Laboratory. I am currently leading an trial on the clinical and cost effectiveness of mobile contingency management as an adjunct to evidence-based cognitive behavioral therapy for Veterans with alcohol use disorder. I am also leading a trial of concurrent evidence-based treatments of posttraumatic stress disorder and tobacco use that combines Cognitive Processing Therapy with cognitive behavioral treatment for smoking cessation. I am primarily interested in program evaluation, data analysis, implementation of evidence-based treatments for mental health problems, and testing innovative treatments for tobacco use, alcohol use, and post traumatic stress disorder.


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