Search the Library
NOTE: This is a new search platform (as of May 2026). If you do a search and don’t get the results you were expecting, please email us at ctnlib@uw.edu to let us know? (If possible, please share your exact search strategy. Thank you!)
Enter keywords and hit Enter (or click the magnifying glass) to search. You can then also select document type or subject/topic to narrow results further (or just use those for searching without a keyword). Results display below this search form.
Document types
Subjects
- CTN-#### format for protocols (CTN-0001, e.g.)
- “exact phrase” (if phrase is not found, it will return results that contain all terms
- word1 NOT word2
- word1 word2 (finds both words)
- Click title to access full-text
- “Show details” reveals abstract & other info
- Checkboxes select items for copy/pasting or printing
- Need help getting a copy of a journal article?
Email ctnlib@uw.edu
Search results
High levels of missing outcome data for biologically confirmed substance use (BCSU) threaten the validity of substance use disorder (SUD) clinical trials. Underlying attributes of clinical trials could explain BCSU missingness and identify targets for improved trial design.
We reviewed 21 clinical trials funded by the NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) and published from 2005 to 2018 that examined pharmacologic and psychosocial interventions for SUD. We used configurational analysis-a Boolean algebra approach that identifies an attribute or combination of attributes predictive of an outcome-to identify trial design features and participant characteristics associated with high levels of BCSU missingness. Associations were identified by configuration complexity, consistency, coverage, and robustness. We limited results using a consistency threshold of 0.75 and summarized model fit using the product of consistency and coverage.
For trial design features, the final solution consisted of two pathways: psychosocial treatment as a trial intervention OR larger trial arm size (complexity=2, consistency=0.79, coverage=0.93, robustness score=0.71). For participant characteristics, the final solution consisted of two pathways: interventions targeting individuals with poly- or nonspecific substance use OR younger age (complexity=2, consistency=0.75, coverage=0.86, robustness score=1.00).
Conclusions: Psychosocial treatments, larger trial arm size, interventions targeting individuals with poly- or nonspecific substance use, and younger age among trial participants were predictive of missing BCSU data in SUD clinical trials. Interventions to mitigate missing data that focus on these attributes may reduce threats to validity and improve utility of SUD clinical trials.
Related protocols: CTN-0002, CTN-0003, CTN-0004, CTN-0006, CTN-0007, CTN-0009. CTN-0013, CTN-0014, CTN-0015, CTN-0017, CTN-0021, CTN-0029, CTN-0030, CTN-0031, CTN-0037, CTN-0044, CTN-0046, CTN-0048, CTN-0051, CTN-0053
HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV-related activities of the CTN during its first 10 years. While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs.
Conclusions: While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed.
Related protocols: CTN-0010, CTN-0013, CTN-0015, CTN-0017, CTN-0018, CTN-0019, CTN-0032
There is need to improve treatment effectiveness for stimulant misusers, and one means of doing so is by tailoring services to account for the common diagnostic comorbidities and psychosocial challenges this population can face. Using its publicly available datasets, this CTN-approved secondary analysis project examined prevalence of alcohol use disorders (AUDs) among primary stimulant misusing treatment-seekers as well as impact of AUD comorbidity on their pre-treatment psychosocial functioning. Upon identifying a primary stimulant misuser subsample (N = 1133) from among aggregated treatment-seekers across eight CTN trials, diagnostic data were used to document lifetime AUD rates. Paired comparisons, stratified by stimulant drug type (e.g., amphetamine, cocaine) then tested the influence of AUD comorbidity on psychosocial indices from the Addiction Severity Index–Lite. A high AUD rate (45%) was found in this client population. Among primary cocaine misusers, those with AUD were more likely to: (1) show elevated Addiction Severity Index composite scores, (2) perceive greater importance of drug treatment, and (3) endorse psychiatric symptoms and perceived need for their treatment. Among primary amphetamine misusers, those with AUD were more likely to endorse specific psychiatric symptoms.
Conclusions: Study findings document AUD comorbidity as a fairly common diagnostic feature of primary stimulant misusers, and suggest it is a pervasive influence on the pre-treatment psychosocial functioning of cocaine misusers. This study demonstrates the utility of CTN common assessment battery for secondary analysis projects, though challenges noted during its conduct highlight the value of consistent data collection and documentation within and across CTN trials.
Related protocols: CTN-0004, CTN-0006, CTN-0007, CTN-0009, CTN-0013, CTN-0017, CTN-0018, CTN-0019
The National Drug Abuse Treatment Clinical Trials Network (CTN) has faced many challenges over its first eleven years. This review explores some of these challenges and the paths the CTN took to meet these challenges, including: designing clinical trials that reflect the CTN’s mission and changing public health needs, finding the synergies in the varied expertise of clinical treatment providers and academic researchers, promoting evidence-based practices, and expanding the Network into mainstream medical practices to reach a broader patient population. Included in this exploration are specific examples from CTN clinical trials.
CTN studies have shown that quality clinical trials can be successfully implemented into practice settings unfamiliar with research logistics by taking clinicians’ practical needs and research knowledge level into account. The challenges yet to be faced in the CTN’s efforts to expand opportunities to offer existing treatments to the segment of the drug-abusing population that utilizes mainstream health care seem large, but not as large as the potential for improvements in public health.
Related protocols: CTN-0001, CTN-0002, CTN-0003, CTN-0004, CTN-0005, CTN-0006, CTN-0007, CTN-0009, CTN-0010, CTN-0011, CTN-0013, CTN-0014, CTN-0015, CTN-0017, CTN-0018, CTN-0019, CTN-0020, CTN-0021, CTN-0027, CTN-0028, CTN-0029, CTN-0030, CTN-0031, CTN-0032, CTN-0037, CTCN-0044, CTN-0047, CTN-0048, CTN-0049
Protocol CTN-0017, “HIV and HCV Prevention in Drug Treatment Settings” was a study of 632 drug injectors that tested three interventions to reduce drug and sex risk behaviors. Participants were randomized to (a) a two-session, HIV/HCV counseling and education (C&E) model added to treatment as usual (TAU), (b) a one-session therapeutic alliance (TA) intervention conducted by outpatient counselors to facilitate treatment entry plus TAU, or (c) TAU. Significant reductions in drug and sex risk behaviors occurred for all three conditions over a 6-month follow-up period. C&E participants reported significantly greater rates of attending an HIV testing appointment, but this was not associated with better risk reduction outcomes. Reporting treatment participation within 2 months after detoxification and self-efficacy to practice safer injection behavior predicted reductions in injection risk behaviors.
Findings indicate that participation in detoxification was followed by significant decreases in drug injection and risk behaviors for up to six months; interventions added to standard treatment offered no improvement in risk behavior outcomes. The study supports the importance of access to detoxification for drug injectors followed by transition to continued treatment.
Related protocols: CTN-0017
This article examines variables that predicted outpatient treatment entry within six months of residential detoxification. Patient data were collected from 632 injection drug users enrolled in a randomized trial conducted at eight detoxification programs within the National Drug Abuse Treatment Clinical Trials Network (CTN) with follow-up assessments conducted at 2, 8, 16, and 24 weeks (protocol CTN-0017, “HIV and HCV Intervention in Drug Treatment Settings”). Detoxification program characteristics were collected during this study and from a survey of CTN treatment organizations. Survival analysis found that estimated proportions of reported outpatient treatment entry varied across sites from .06 to .72. A model-building approach determined variables significantly associated with outpatient treatment entry. The best predictive model contained five program-level variables: accreditation, fewer beds, longer stays, shorter distance between detoxification and outpatient unit, and the larger city population.
This study suggests that smaller detoxification units with longer lengths of stay and treatment services nearby may boost rates of continuing treatment beyond detoxification for injecting drug users. In addition, innovative research should combine what are typically separate areas of inquiry, for example, matching patients to program variations and examining multilevel interventions that target both patient-level change and programmatic quality improvement.
Related protocols: CTN-0017
Multisite effectiveness trials such as those carried out in the National Drug Abuse Treatment Clinical Trials Network (CTN) are a critical step in the development and dissemination of evidence-based treatments because they address how such treatments perform in real-world clinical settings. Several possible experimental designs may be chosen for such effectiveness trials. These include (a) a new treatment intervention (Tx) is compared to an existing mode of community based treatment as usual (TAU): Tx versus TAU; (b) a new intervention is added to TAU and compared to TAU alone: Tx + TAU versus TAU; or (c) a new intervention is added to TAU and compared to a control condition added to TAU: Tx + TAU versus control + TAU. Each of these designs addresses a different question and has different potential strengths and weaknesses. As of December 2009, the primary outcome paper had been published for 16 of the multisite randomized clinical trials conducted in the CTN, testing various treatments for drug abuse, HIV risk behavior, or related problems.
This paper systematically examines, for each of the completed trials, the experimental design type chosen and its original rationale, the main findings of the trial, and the strengths and weaknesses of the design in hindsight. Based on this review, recommendations are generated to inform the design of future effectiveness trials on treatments for substance abuse, HIV risk, and other behavioral health problems. Addressing the right questions, looking closely at effect size and power, as well as internal versus external validity, and more consideration for three-arm designs and cost-effectiveness will serve well the goals of effectiveness research.
Related protocols: CTN-0001, CTN-0002, CTN-0003, CTN-0004, CTN-0005, CTN-0006, CTN-0007, CTN-0009, CTN-0010, CTN-0011, CTN-0013, CTN-0015, CTN-0017, CTN-0018, CTN-0019, CTN-0021
A multisite, randomized trial within the National Drug Abuse Treatment Clinical Trials Network (protocol CTN-0017, “HIV and HCV Intervention in Drug Treatment Settings”) was conducted to test three interventions to enhance treatment initiation following detoxification: 1) a single session, therapeutic alliance intervention (TA) added to usual treatment; 2) a 2-session, counseling and education, HIV/HCV risk reduction intervention (C&E), added to usual treatment; and 3) treatment as usual (TAU) only. Injection drug users (n=632) enrolled in residential detoxification at 8 community treatment programs were randomized to 1 of the 3 study conditions. There was a significant difference between TA participants and those receiving TAU in reported outpatient treatment entry. TA participants reported entering outpatient treatment sooner and in greater numbers than TAU participants. Reported treatment entry for C&E fell between TA and TAU with no significant differences between C&E and the other conditions. There were no differences among the interventions in retention, as measured by weeks of outpatient treatment for all participants who reported treatment entry.
Alliance building interventions appear to be effective in facilitating transfer from detoxification to outpatient treatment, but additional treatment engagement interventions may be necessary to improve retention.
Related protocols: CTN-0017
This manual is a training guide for the Therapeutic Alliance intervention used in NIDA’s National Drug Abuse Treatment Clinical Trials Network (CTN) protocol #0017, “HIV and HCV Risk Reduction Interventions in Drug Detoxification and Treatment Settings.” The CTN is a cooperative research group that conducts clinical trials in community based drug treatment programs. Its mission is to join researchers and treatment providers in identifying research-based treatments which are effective in community treatment settings. Protocol CTN-0017 aims to evaluate the effectiveness of two interventions in reducing HIV and HCV risk behavior related to intravenous drug use. This manual is about one of the interventions, the Therapeutic Alliance (TA) intervention, which is designed to increase clients? entry into outpatient treatment following detox. It includes an overview of the research on Therapeutic Alliance, its goals, and a detailed session plan for clinicians to use when implementing the TA intervention in their community treatment programs.
Related protocols: CTN-0017
This presentation, part of a symposium at the CPDD meeting entitled, “Primary Findings from HIV/AIDS Research in the NIDA Clinical Trials Network” (chaired by Donald A. Calsyn), describes protocol CTN-0017, “HIV and HCV Intervention in Drug Treatment Settings.” This study aimed to reduce injection-related HIV and HCV risk behaviors, while also increasing treatment entry and retention.
Three interventions were compared: NIDA Counseling & Education Intervention (C&E), which offers HIV & HCV education and protective skills training and encouragement; Therapeutic Alliance Intervention (TA), which uses a single session with an outpatient counselor to identify treatment goals, tasks, and expectations; and Treatment as Usual (TAU), which includes typical clinic procedures such as risk reduction education and referral for HIV testing and continuing care. The presentation ends with an analysis of the “outcomes so far.”
Related protocols: CTN-0017
Prevention and treatment of HIV/AIDS among drug users continue to be vexing problems. Scientifically validated interventions have been developed to prevent and treat HIV/AIDS among substance users. The Clinical Trials Network (CTN) of the National Institute on Drug Abuse (NIDA) is conducting multi-site clinical trials, with emerging results that address both prevention and treatment of HIV/AIDS. This is a report of preliminary results from several of those trials, presented at a workshop of the College on Problems of Drug Dependence (June 17-22, 2006). Lawrence Brown surveyed over 120 CTN clinics and reports on the state of the clinics in treating HIV/AIDS and other infectious diseases. Robert Booth summarized preliminary data from over 600 participants in a multi-site trial of HIV and hepatitis C virus (HCV) interventions in drug detoxification settings. Donald Calsyn reported preliminary results from an effectiveness trial of a gender-specific, action-oriented, safer-sex group intervention for 575 men in drug treatment programs. Susan Tross reported on a similar study focusing on 515 women in 12 clinics. Yong Song presented the perspective of treatment programs in conducting clinical trials. Jacques Normand added comments from the perspective of the Director of the NIDA AIDS research program.
Related protocols: CTN-0012, CTN-0017, CTN-0018, CTN-0019
Ethnic minorities have significantly higher rates of unmet needs for treatment of substance use disorders and are often underrepresented in clinical trials and treatment research. The National Drug Abuse Treatment Clinical Trials Network (CTN) was established in 1999 to conduct research in a wide variety of community based treatment programs across the United States. Through its size and scope, the CTN provides a unique opportunity to address a variety of underserved populations, and in particular to evaluate access to and effectiveness of treatments for ethnic minorities. The CTN has continually sought to reduce barriers to all its studies and has attended carefully to recruitment and retention of women and ethnic minority groups.
This article describes a symposium from the June 2006 CPDD annual meeting that included four presentations on ongoing CTN activities and strategies used to address the issues of ethnic disparities. Kathleen Carroll described a protocol developed specifically to address retention in treatment among Spanish-speaking substance users. Ray Daw described the special issues raised in clinical research among American Indian communities, including those encountered by a CTN protocol that was adapted on site so it could be implemented among American Indian communities. Kathryn Magruder summarized results of a secondary analysis of CTN data, evaluating rates of retention among ethnical minorities. And Lawrence Brown described a secondary analysis of a CTN survey study on national practices regarding the availability of specialized treatment for sexually transmitted diseases in drug abuse treatment, focusing specifically on services for ethnic minorities.
Related protocols: CTN-0012, CTN-0017, CTN-0020, CTN-0021
This presentation describes CTN protocol 0017, “HIV and HCV Interventions in Drug Treatment Settings.” This study tests two strategies to reduce the risk of contracting HIV or HCV by reducing risk behaviors in patients undergoing drug detoxification. The first includes pretest counseling, testing, posttest counseling, and the provision of HIV/HCV results. The second strategy, called therapeutic alliance, provides clients with information to guide them through the process of role induction and aims to facilitate transition to continuing care for drug treatment.
The presentation describes the Nodes and CTPs involved in CTN-0017, as well as its objectives, methods, and progress of the study so far.
Related protocols: CTN-0017
This brochure, intended for participants thinking about joining the CTN-0017 clinical trial (HIV and HCV Intervention in Drug Treatment Settings), provides an overview of the study’s aims, a description of what participation will involve, and information about compensation.
Related protocols: CTN-0017
This is the Counseling and Education (C&E) Intervention Training Manual for protocol CTN-0017, “HIV and HCV Risk Reduction in Detoxification Settings.” This training manual is for CTN-0017 interventionists and supervisors, and is intended as a training tool and a quick reference guide for delivering the CTN-0017 protocol. It provides step-by-step instructions on how to conduct all aspects of the CTN-0017 C&E intervention and provides guidelines and templates for the development of Standard Operating Procedures (SOPs) for aspects of the protocol that will be specific to a particular site.
This manual is a revised, updated version of the 1993 NIDA HIV Counseling and Education Intervention Model. It has been tailored to fit the CTN-0017 C&E intervention and to include HCV counseling and education in the intervention. The manual includes implementation requirements, intervention guidelines, scripts for interventionists, cue cards for sessions one and two, guidelines and outlines for C&E intervention SOPs, and more.
Related protocols: CTN-0017