CPDD 72nd Annual Meeting • Scottsdale, Arizona - The College on ...

181
BRIEF INTERVENTION TO REDUCE CAFFEINE
CONSUMPTION IN CAFFEINE-DEPENDENT TREATMENT
SEEKERS.
Daniel P Evatt 1 , L M Juliano 2 , J Cohen 1 , R R Griffiths 1 ; 1 Psychiatry and
Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore,
MD, 2 Psychology, American University, Washington, DC
Aims: Physicians frequently advise caffeine reduction or cessation in individuals
who have certain medical conditions. Some daily users are unable to reduce or
quit caffeine use, despite a desire to do so. <strong>The</strong> purpose of this study was to develop
a brief manualized treatment to reduce caffeine consumption in caffeinedependent
users.
Methods: Participants were 106 daily caffeine users who were interested in cutting
back or quitting their caffeine consumption. Fifty-four participants, who
used 200mg or more of caffeine per day and fulfilled DSM-IV criteria for substance
dependence applied to caffeine, returned for the treatment session.
Participants were randomized to receive a one-hour treatment after an
Immediate (return in 1-2 weeks) or Delay (return in 5-6 weeks) condition. Daily
caffeine diaries were kept from 1 week before treatment to 5 weeks post-treatment.
Timeline follow-back assessments were taken at 6, 12, and 26 weeks.
Results: Mean age was 41.4 years. <strong>The</strong> majority of the sample was Caucasian
(80%) and female (59%). Forty-four percent were married and 72% employed.
A repeated measures ANOVA was conducted with Time (Screening, Treatment)
and Delay (Delay, Immediate) entered as factors. A separate analysis was conducted
with Time (Treatment, Week1, Week2, Week3, Week4, Week5) and
Delay (Delay, Immediate) entered as factors. No significant effect of Delay was
observed in either analysis. Findings revealed a significant reduction in caffeine
consumption across the first 5 weeks of treatment, F(2.18, 67.52) = 36.98, p <
.001, ηp2 = .54. Mean reductions in caffeine from Treatment (468.9mg) to
Week5 (159.1) were 66%. Reductions were maintained at 6, (159.7mg), 12
(136.2mg), and 26 weeks (133.6mg).
Conclusions: <strong>The</strong> study demonstrates that a brief behavioral treatment is efficacious
for reducing caffeine intake in caffeine dependent users.
Financial Support: Supported by NIDA R01 DA03890
183
COMPARING HEROIN USERS AND PRESCRIPTION
OPIOID USERS SEEKING SUBOXONE® TREATMENT FOR
OPIOID DEPENDENCE.
Jacqueline Fahey, M Hillhouse, J Jenkins, R Rawson, W Ling; Integrated
Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA
Aims: <strong>The</strong> number of Americans receiving treatment for abuse of pain medications
increased 167% from 360,000 to 601,000 persons between 2002 and 2008
(SAMHSA, 2009), and treatment providers are likely treating a growing percentage
of prescription opioid (PO) users. Research has compared heroin and
PO users in both opioid treatment program (OTP) and office-based settings
(Banta-Green et al., 2009; Torrington et al., 2007), and the current study
expands study findings to include opioid-dependent participants receiving
Suboxone® in a research clinic setting.
Methods: In an ongoing NIDA-funded trial comparing the effectiveness of combined
pharmacotherapy and behavioral therapy for opioid dependence, the first
177 treatment-seeking participants self-reported being primarily heroin users (n
= 113) or PO users (n = 64).
Results: Baseline analyses show that the heroin and PO groups did not vary by
gender, education level, age at first opioid use, or recent poly-substance use.
Preliminary analyses indicate differences between the two groups, including
mean number of lifetime drug treatment episodes [heroin = 6.13(8.49); PO =
2.12(2.38)], and pain as the main reason for seeking treatment (5.3% of heroin
users compared to 16.9% of PO users). Interestingly, a greater percentage of the
heroin group reported using other opioids (96.4%), whereas less than half of the
PO group (49.2%) reported past heroin use. Also presented are findings on
group differences in HIV risk behavior, medical and psychiatric problems, and
treatment retention.
Conclusions: Findings from this study have important implications for treatment
providers, who may use the information to adapt treatment plans for either
heroin- or PO-dependent patients presenting for treatment with Suboxone®.
Financial Support: NIDA Grant DA020210
<strong>CPDD</strong> <strong>72nd</strong> <strong>Annual</strong> <strong>Meeting</strong> <strong>•</strong> <strong>Scottsdale</strong>, <strong>Arizona</strong>
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182
THE INFLUENCE OF NEURO-COGNITIVE IMPAIRMENT
ON INTERVENTION OUTCOMES AMONG INJECTION
DRUG USERS LIVING WITH HIV/AIDS.
I Ezeabogu, Michael Copenhaver, J Potrepka, A Meier; University of
Connecticut, Storrs, CT
Aims: Drug- and sex-related HIV risk behaviors and sub-optimal adherence to
HIV medication regimens can jeopardize the health of HIV–infected injection
drug users (IDUs) and threaten community health. Findings to date indicate that
it is feasible to deliver a brief behavioral risk reduction/medication adherence
group intervention to HIV-infected IDUs in a community-based setting. Being
adherent to HAART or being able to successfully participate in behavioral interventions
targeting adherence and harm reduction often requires a relatively high
level of cognitive abilities. HIV infection and substance abuse are known to independently
affect the central nervous system and this can result in neuro-cognitive
impairment. In combination, their effects can be even more profound and
this is directly relevant to intervention development because a significant number
of people living with HIV/AIDS have a positive history of substance abuse.
We aimed to examine the impact of cognitive impairment on outcomes among
HIV-infected IDUs participating in our CHRP+ intervention.
Conclusions: We evaluated the extent to which changes in Information,
Motivation, and Behavioral skills (IMB) with respect to medication adherence
and sex- and drug-risk behavior outcomes are predicted by cognitive impairment
following the brief 4-session Community-Friendly Health Recovery Program for
HIV-infected Drug Users (CHRP+). Findings suggest that it may be helpful to
specifically tailor such behavioral interventions to accommodate cognitive
impairment. Implications for the design of future interventions are discussed.
Financial Support: Funding provided by NIH/NIDA K23 DA17015
(Copenhaver PI), Optimizing HIV prevention for HIV-positive Injection
Drug Users.
184
ESTIMATED CANNABIS-ASSOCIATED RISK OF
DEVELOPING A NEWLY INCIDENT DEPRESSION SPELL:
FOCUS ON EARLY-ONSET CANNABIS USE.
Brian Fairman, J C Anthony; Epidemiology, Michigan State University, East
Lansing, MI
Aims: In recent studies, there has been focus on suspected mood disturbances
due to early-onset cannabis use (EOCU with onset < 18 years). We seek to estimate
suspected EOCU-associated excess risk of experiencing a depression spell
in adulthood.
Methods: Data are from the 2005-2007 United States National Surveys on Drug
Use and Health for non-institutionalized community-dwelling residents aged 12
or older (n=103,432 after exclusion of 54,719 persons 12-17 years old at survey,
8,169 with pre-adult depression spell, and 299 missing on crucial data). Logistic
regression was used to estimate relative risk (RR) while taking into account sampling
weights and the complex sample structure.
Results: An estimated 31% of adult onset depression spell cases had used
cannabis before 18 compared to 22% of non-cases (unadjusted RR = 1.7; 95%
Confidence Interval, CI = 1.6, 1.8; p