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 Applications of Technology to Enhance Substance Abuse Treatment |
| Sunday, May 30, 2021 |
| 9:00 AM–10:50 AM |
| Online |
| Area: BPN/CSS; Domain: Applied Research |
| Chair: Forrest Toegel (Johns Hopkins University School of Medicine) |
| Discussant: August F. Holtyn (Johns Hopkins University School of Medicine) |
| CE Instructor: Sean Regnier, Ph.D. |
| Abstract: Recent technological advances have made it possible to navigate barriers that stand in the way of effective substance abuse treatment. Technology has made it easier to link patients to treatment, retain them in treatment, monitor their progress, and deliver interventions and consequences that can enhance treatment effects. The present symposium arranges four recent studies that apply technology to enhance the treatment of substance abuse. The goal of this symposium is to describe new methods to apply the technology that is available to behavior analysts interested in substance abuse treatment, and provide behavioral scientists with potential directions for using technology in future clinical research and practice. |
| Instruction Level: Intermediate |
| Keyword(s): addiction, behavioral pharmacology, substance abuse, technology |
| Target Audience: This symposium is for students and behavior analysts interested in the application of operant principles to the treatment of substance abuse. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) Describe some relevant target behavior for operant procedures aimed to treat substance abuse; (2) Identify several logistical barriers to implementing effective substance abuse treatment remotely; (3) Describe how technology can be applied to enhance the treatment of substance abuse. |
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| Computer-Based Opioid Education for Out-of-Treatment Adults With Opioid Use Disorder |
| FORREST TOEGEL (Johns Hopkins University School of Medicine), Matthew Novak (Johns Hopkins University School of Medicine), Kenneth Silverman (Johns Hopkins University School of Medicine), August F. Holtyn (Johns Hopkins University School of Medicine) |
| Abstract: Opioid overdose is a major contributor to death among U.S. citizens. This study used a computer-based education program to teach out-of-treatment adults with opioid use disorder (N=40) about opioids; preventing, detecting, and responding to an opioid overdose; and FDA-approved medications prescribed to treat opioid use disorder. The education program contained three courses. Each course presented information and required participants to answer multiple-choice questions. All answers produced immediate feedback. Participants earned incentives for providing correct answers and progressing through each course. We evaluated the program using a multiple-probe design in which a test was delivered before and after participants completed each course. Each test contained 50 questions and was divided into three subtests that corresponded to questions from each of the education courses. Accuracy on each subtest increased reliably after participants completed the course that corresponded to that subtest. Accuracy on subtests was unchanged prior to completion of the relevant course and increases in accuracy were retained across tests that followed the relevant course. These increases occurred at similar rates across participants independent of education, employment, and poverty status. We hope that this study will contribute to the body of research aimed to prevent opioid overdose. |
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| Bridge to Medication Assisted Treatment |
| Anthony DeFulio (Western Michigan University), SEAN REGNIER (Western Michigan University) |
| Abstract: Opioid Use Disorder (OUD) is a major public health crisis. Many people with OUD, especially those who have overdosed, receive treatment in an Emergency Department. However, few of them enroll in treatment, even if they receive care and referral to treatment while in an emergency department. Medication assisted treatments (MAT) are among the most effective treatments for opioid use disorder. Promoting entry into MAT in people who received OUD related care in an emergency department could reduce the risk of overdose. Contingency management (CM) interventions have successfully improved a broad range of health behaviors including promoting physical activity, medication adherence and treatment attendance. In CM, incentives are made available contingent upon objective verification that the patient has engaged in a specified behavior, such as the ones described above. The purpose of this ongoing study is to develop a smartphone-based intervention to promote entry and adherence to MAT for people with opioid use disorder who have recently received care in an emergency department. In this presentation an overview of the study procedures will be provided, and a case study will be described to highlight the aforementioned barriers and how remote access to the platform was able to navigate them. |
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| The Feasibility, Acceptability, and Initial Efficacy of a Remotely Delivered, Financial-Incentive Intervention to Initiate Vaping Abstinence in Young Adults |
| CAITLYN UPTON (Rowan University), Schyler Newman (Rowan University), Bethany R. Raiff (Rowan University) |
| Abstract: Electronic cigarette use (i.e., vaping) is becoming more popular among young adults, leading to concerns about their long-term health effects, as well as their potential to lead to future combustible cigarette use. Interventions to promote vaping abstinence have not been explored and are sorely needed. The present study examined the feasibility, acceptability, and preliminary efficacy of a remotely delivered, abstinence-contingent financial incentive intervention to reinforce nicotine abstinence from vaping among young adults. Using a multiple-baseline design, college students (N=8) were given saliva cotinine testing kits to verify nicotine abstinence from home, remotely, via every-other-day teleconferencing calls. During baseline condition (2, 4, or 6 day duration), financial incentives ($3) were delivered contingent on submitting cotinine samples, regardless of cotinine levels. During an abstinence condition (14 days for all participants), escalating financial bonuses ($2, $7, $12, etc) were delivered contingent on negative cotinine samples only. All participants quit vaping nicotine during the 2-week pilot intervention when the abstinence-contingent bonuses were introduced. Participants rated the intervention favorably on all measures. This study supported the feasibility, acceptability, and preliminary efficacy of this remotely delivered intervention. |
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| Development and Initial Efficacy of a Digital Episodic Future Thinking Intervention for Reducing Cannabis Use |
| MICHAEL SOFIS (Geisel School of Medicine at Dartmouth College), Shea M. Lemley (Geisel School of Medicine at Dartmouth College), Nicholas Jacobson (Geisel School of Medicine at Dartmouth College), Alan J. Budney (Geisel School of Medicine at Dartmouth College) |
| Abstract: Cannabis use is associated with deficits in episodic memory, the ability to retrieve and recombine details of past events, and delay discounting (DD), defined as the valuation of delayed rewards. Episodic memory and DD are both required to simulate valuable future events during Episodic Future Thinking (EFT), an intervention that prompts mental simulation of positive future events. This presentation will summarize three studies dedicated to developing a digital, remote EFT intervention to reduce cannabis use among active users. Study 1 tested whether simulating EFT across life domains (social, leisure, work/financial, and health), Domain-Specific Episodic Future Thinking (DS-EFT), reduced DD and cannabis relative to EFT and an Episodic Recent Thinking (ERT) control. DS-EFT alone engendered greater reductions in cannabis grams (d=.54) than ERT one-week post-intervention. DD did not differ between conditions. Study 2 tested the feasibility of delivering an abbreviated, digital DS-EFT across six weekly sessions. Participants have completed 88% of sessions (ongoing). In Study 3, an RCT (DS-EFT/ERT) will be used to compare DS-EFT sessions on cannabis use and will test whether DD and episodic memory mediate the effects of DS-EFT on cannabis use. Preliminary RCT findings will be presented and the findings from these studies will be discussed. |
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