TY - JOUR
T1 - A randomized trial of concurrent smoking-cessation and substance use disorder treatment in stimulant-dependent smokers
AU - Winhusen, Theresa M.
AU - Brigham, Gregory S.
AU - Kropp, Frankie
AU - Lindblad, Robert
AU - Gardin, John G.
AU - Penn, Pat
AU - Hodgkins, Candace
AU - Kelly, Thomas M.
AU - Douaihy, Antoine
AU - McCann, Michael
AU - Love, Lee D.
AU - DeGravelles, Eliot
AU - Bachrach, Ken
AU - Sonne, Susan C.
AU - Hiott, Bob
AU - Haynes, Louise
AU - Sharma, Gaurav
AU - Lewis, Daniel F.
AU - Van Veldhuisen, Paul
AU - Theobald, Jeff
AU - Ghitza, Udi
PY - 2014/4
Y1 - 2014/4
N2 - Objective: To evaluate the impact of concurrent treatments for substance use disorder and nicotine-dependence for stimulant-dependent patients. Method: A randomized, 10-week trial with follow-up at 3 and 6 months after smoking quit date conducted at 12 substance use disorder treatment programs between February 2010 and July 2012. Adults meeting D5M-IV-TR criteria for cocaine and/or methamphetamine dependence and interested in quitting smoking were randomized to treatment as usual (n 271) or treatment as usual with smoking- cessation treatment (n 267). All participants received treatment as usual for substance use disorder treatment. Participants assigned to treatment as usual with concurrent smoking-cessation treatment received weekly individual smoking cessation counseling and extended- release bupropion (300 mg/d) during weeks 1 10. During post-quit treatment (weeks 4 10), participants assigned to treatment as usual with smoking-cessation treatment received a nicotine inhaler and contingency management for smoking abstinence. Weekly proportion of stimulant- abstinent participants during the treatment phase, as assessed by urine drug screens and self-report, was the primary outcome. Secondary measures included other substance/nicotine use outcomes and treatment attendance. Results:There were no significant treatment effects on stimulant-use outcomes, as measured by the primary outcome and stimulant-free days, on drug-abstinence, oron attendance. Participants assigned to treatment as usual with smoking-cessation treatment, relative to those assigned to treatment as usual, had significantly better outcomes for drug-free days at 6 month follow up (X2i 4.09, P <.05), with a decrease in drug-free days from baseline of 1 .3°o in treatment as usual with smoking cessation treatment and of 7.6°o in treatment as usual. Participants receiving treatment as usual with smoking-cessation treatment, relative to those receiving treatment as usual, had significantly better outcomes on smoking point prevalence abstinence (25.5°o vs 2.2°o; X2i 44.69, P<.001;OR 18.2). Conclusions:These results suggest that providing smoking-cessation treatment tu illicit stimulant-dependent patients in outpatient substance use disorder treatment will not worsen, and may enhance, abstinence from nonnicotine substance use. Trial Registration: Clinica ITria ls.gov identifier: NCTO 1077024
AB - Objective: To evaluate the impact of concurrent treatments for substance use disorder and nicotine-dependence for stimulant-dependent patients. Method: A randomized, 10-week trial with follow-up at 3 and 6 months after smoking quit date conducted at 12 substance use disorder treatment programs between February 2010 and July 2012. Adults meeting D5M-IV-TR criteria for cocaine and/or methamphetamine dependence and interested in quitting smoking were randomized to treatment as usual (n 271) or treatment as usual with smoking- cessation treatment (n 267). All participants received treatment as usual for substance use disorder treatment. Participants assigned to treatment as usual with concurrent smoking-cessation treatment received weekly individual smoking cessation counseling and extended- release bupropion (300 mg/d) during weeks 1 10. During post-quit treatment (weeks 4 10), participants assigned to treatment as usual with smoking-cessation treatment received a nicotine inhaler and contingency management for smoking abstinence. Weekly proportion of stimulant- abstinent participants during the treatment phase, as assessed by urine drug screens and self-report, was the primary outcome. Secondary measures included other substance/nicotine use outcomes and treatment attendance. Results:There were no significant treatment effects on stimulant-use outcomes, as measured by the primary outcome and stimulant-free days, on drug-abstinence, oron attendance. Participants assigned to treatment as usual with smoking-cessation treatment, relative to those assigned to treatment as usual, had significantly better outcomes for drug-free days at 6 month follow up (X2i 4.09, P <.05), with a decrease in drug-free days from baseline of 1 .3°o in treatment as usual with smoking cessation treatment and of 7.6°o in treatment as usual. Participants receiving treatment as usual with smoking-cessation treatment, relative to those receiving treatment as usual, had significantly better outcomes on smoking point prevalence abstinence (25.5°o vs 2.2°o; X2i 44.69, P<.001;OR 18.2). Conclusions:These results suggest that providing smoking-cessation treatment tu illicit stimulant-dependent patients in outpatient substance use disorder treatment will not worsen, and may enhance, abstinence from nonnicotine substance use. Trial Registration: Clinica ITria ls.gov identifier: NCTO 1077024
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U2 - 10.4088/JCR.13m08449
DO - 10.4088/JCR.13m08449
M3 - Article
C2 - 24345356
AN - SCOPUS:84899739109
SN - 0160-6689
VL - 75
SP - 336
EP - 343
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 4
ER -