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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Provenance

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

Moore

Scott Daniel Moore

Professor 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.

Wilson

Sarah M Wilson

Assistant Professor in Psychiatry and Behavioral Sciences

Sarah M. Wilson is an Assistant Professor in the Department of Psychiatry & Behavioral Sciences at the Duke University School of Medicine, with a secondary appointment in the Department of Population Health Sciences and a faculty affiliation in the Duke Center for Health Policy and Inequalities Research. She is a Research Investigator and Co-Lead of the Diversity, Equity, and Inclusion Core at the Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT COIN). She also serves as the Associate Director of the Duke Center for AIDS Research Social and Behavioral Sciences Core.

Dr. Wilson's research focuses on access to care and systems-level healthcare change to improve inequities in populations who experience systemic discrimination, including Black, Indigenous, and People of Color (BIPOC), individuals with low income, sexual and gender minorities, and specific populations of U.S. Military Veterans. Her clinical work as a licensed clinical psychologist focuses on mental health care for patients with comorbid mental health concerns and stress due to systemic discrimination, as well as training for health care professionals on LGBTQ-affirmative care.

Dr. Wilson has expertise in health equity, social determinants of health, community engagement, intervention development, and implementation science. She is a former Fellow in the Implementation Research Institute. She leads VA and NIH research studies related to implementation science and health equity in the areas of tobacco cessation, provider implicit bias, pre-exposure prophylaxis for HIV, and LGBTQ-affirmative mental healthcare.

Blalock

Daniel Blalock

Associate Consulting Professor in the Department of Psychiatry and Behavioral Sciences

I am a behavioral health researcher with a background in Clinical Psychology and Experimental Psychology.  My research interests include broad processes of behavior change and self-regulation as well as psychometric measurement and research methods/statistics.  My specific research endeavors include 1) the measurement and behavior change applicability of constructs related to self-control, 2) measurement and interventions to improve self-regulatory health behaviors including medication adherence and substance use, and 3) measure development and psychometrics as related to self-reported and patient-reported outcomes.

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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