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Substance abuse is a leading cause of death and disability throughout the world. The mission of the National Institute on Drug Abuse (NIDA) is to lead the United States in bringing the power of science to bear on drug abuse and addiction. This charge has two critical components: (a) strategic support of research across a broad range of disciplines and (b) rapid, effective dissemination of research results that can improve prevention and treatment efforts, with potential to inform policy. The NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) and the Blending Initiative are critical elements of this strategy, and the social work field is poised to use these resources to expand its role in the dissemination and implementation of NIDA’s mission.
The article describes the CTN and Blending Initiatives in general, the CTN Dissemination Library, CTN Data Share, and each of the Blending Initiative training products developed to date. NIDA, the Blending Initiative, and the CTN offer great promise toward implementation of evidence-based practices, and social workers are encouraged to seize every opportunity to initiate and remain engaged in substance abuse treatment, research, and training activities.
This conference took place on July 13, 2012 in the Baltimore-Washington Metro area. It was sponsored by the Central East Addiction Technology Transfer Center (a program of the Danya Institute), and the Mid-Atlantic Node of the National Drug Abuse Treatment Clinical Trials Network (CTN). It featured presentations about the NIDA/SAMHSA Blending Products, a suite of training tools developed by the NIDA/SAMHSA Blending Initiative and aimed at helping reduce the gap that exists between the publication of research results and the impact on treatment delivery. The initiative incorporates collaboration between clinicians, scientists, and experienced trainers to catalyze the creation of user-friendly treatment tools and products and facilitate the adoption of research-based interventions into front-line clinical settings. Through this initiative, NIDA and SAMHSA’s Addiction Technology Transfer Centers (ATTCs) disseminate treatment and training products based on results from studies conducted by the National Drug Abuse Clinical Trials Network (CTN) as well as other NIDA-supported research. The audience for this conference was made up of practitioners in the substance abuse treatment workforce and was intended to introduce the variety of tools available in the Blending Products suite to clinicians, giving them an opportunity to learn how to implement the various evidence-based practices that have emerged from the CTN.
Presentations are available for viewing on YouTube:
Overview of the Clinical Trials Process, Maxine Stitzer, PhD
Taking a Look at the NIDA Blending Products, Christine Higgins, MA
MIA-Step, Christine Higgins, MA
Promoting Awareness of Motivational Incentives (PAMI), Melissa Wesner, LCPC
MI-Presto, Lori Peterson
Looking at the NIDA Treatment Protocols from a Program Director’s Perspective, Patricia Stabile, LCSW-C
The Perspective from the Clinical Side, Amy Pearce
The NIDA Clinical Trials Network conducted the multisite “HIV Rapid Testing and Counseling” study (protocol CTN-0032) to examine the efficacy of on-site rapid testing and risk-reduction counseling in increasing the receipt of results and reducing HIV risk behaviors of patients in substance abuse treatment programs. Research showed that offering this testing in substance abuse treatment centers substantially increased receipt of HIV test results and identified persons who were unaware of their HIV infection. Testing may be implemented for less than $40 per rapid HIV test and is cost-effective. Substance use treatment patients are receptive to on-site testing and are more likely to get tested than if they are referred to another agency for testing.
The National Institute on Drug Abuse (NIDA) and the Substance Abuse Mental Health Services Administration’s Addiction Technology Transfer Network have partnered to promote the dissemination of the results from drug abuse research. This collaboration (the blending of research and practice) has produced numerous research-based training workshops and products designed specifically for substance abuse treatment providers. The HIV Rapid Testing Blending Product can be found online at http://www.nattc.org/rapidtesting and includes: video interviews with researchers, treatment providers, and clients about the value of onsite rapid HIV testing; a fact sheet that provides details about the need for onsite testing and the outcomes of the CTN protocol; and a web guide that provides links to valuable testing and other implementation resources.
Related protocols: CTN-0032
[Note: the CD version of this product is no longer available. Factsheets and links to additional resources may still be available at the link provided.]
This new CD-ROM features copies of the three previous buprenorphine-related Blending Products (Buprenorphine Treatment, Short-Term Opioid Withdrawal Using Buprenorphine, and Buprenorphine Treatment for Young Adults), bundled together with the new Prescription Opioid Addiction Treatment Study (POATS) product.
The new POATS product includes a clinician training program and manual, PowerPoint presentation, resource list, fact sheets, and additional materials to help clinicians implement and promote buprenorphine treatment in their practices.
This CD-ROM compilation includes resources in a variety of formats, including training manuals (PDFs), PowerPoint presentations, short video clips, research articles, and other resources.
This one-hour webinar, produced by the National Drug Abuse Treatment Clinical Trials Network (CTN) Clinical Coordinating Center for CTN members and the public, provides an overview of how the wealth of data that has been generated from the CTN has influenced changes in health care. The webinar begins with a description of the CTN network and its infrastructure; describes all of the studies carried out by the CTN to date, as well as new protocols currently in development; and explains the main processes by which research outcomes are disseminated to those in the field (via Blending Team products and the CTN Dissemination Library, for example). Dr. Tai concludes with a discussion about the future aims of the CTN, its challenges and its opportunities.
The target audience is CTN members and other researchers and clinicians in the substance abuse field.
Presented by Betty Tai, PhD, Center for the Clinical Trials Network, NIDA.
Additional Resources:
Download slides (pdf)
This presentation examines the variety of barriers that get in the way of implementation of medication-assisted treatments for substance abuse. Barriers can be encountered at every level of treatment, from the client level, to the clinician, organizational, and environmental (regulatory, e.g.) levels. Attitudes of both clinicians and patients when it comes to taking medications to treat substance abuse are a common barrier, with many believing drug addiction should not be treated with a drug, or that abstinence is the only approach. MAT itself can be a barrier, if medications are unavailable, dosage is insufficient, or patients fail to comply.
The presentation ends with a discussion of methods for reducing barriers to MAT, including offering medications at reduced cost, increasing access to medical personnel in your area, and education/training (such as the NIDA/SAMHSA Blending Team Products on buprenorphine or Addiction Technology Transfer Center (ATTC) trainings). Participation in medication trials, such as the Ohio Valley Node’s involvement in the National Drug Abuse Treatment Clinical Trials Network’s buprenorphine studies (CTN-0001 and CTN-0002) can help introduce clinicians and treatment centers to evidence-based practices for MAT, and decrease some of the barriers to implementation in their organizations.
Related protocols: CTN-0001, CTN-0002
Motivational Incentives: Positive Reinforcers to Enhance Successful Treatment Outcomes (MI:PRESTO) is an interactive on-line course that focuses on the process of adopting Motivational Incentives in a clinical setting. By design, this course builds upon the Addiction Technology Transfer Center Network’s Technology Transfer Conceptual Model. Highlighted within this model is a multidimensional process that promotes the use of an innovation, in this case Motivational Incentives.
This free, self-guided, online learning tool assists Clinical Supervisors and other behavioral healthcare practitioners to learn and experience how to utilize the 7 Principles of Motivational Incentives introduced in PAMI, to facilitate the adoption of Motivational Incentives as an effective evidence-based practice aimed at reducing drug abuse and promoting positive outcomes for patients.
Related protocols: CTN-0006, CTN-0007
THIS PRODUCT IS NO LONGER AVAILABLE. The Motivational Incentives Implementation Software (MIIS) is available at no cost. This platform, developed by the National Institute on Drug Abuse, provides the mechanisms to: assist researchers, clinicians, and counselors in utilizing and applying Motivational Incentives for treating patients with substance use disorders; and maintain information about clinic patients as well as in the implementation and calculation of incentives based on the defined parameters. MIIS is secure, easy to use, and easy to implement. The user interface allows patient information and activities to be stored and can manage patient appointments and supply detailed reports about patient progress. Patients are automatically awarded draws as an incentive for attendance and abstinence. MIIS can be configured to select prizes and provide draws in varying escalation schedules that are sensitive to patient history of compliance and relapse. The software also maintains a record of prizes awarded to patients.
This product has been combined with two other MI Blending Team Products, PAMI and MI:PRESTO to form a “Motivational Incentives (MI) Package.” MIIS has been discontinued; the other two products are available here: https://collaborativeforhealth.org/bettertxoutcomes/.
Related protocols: CTN-0006, CTN-0007
This presentation provides an overview of the origins of the National Drug Abuse Treatment Clinical Trials Network, established by NIDA in part to address the issues raised by an IOM report decrying the “gap” between research and treatment. After the CTN was established, NIDA and SAMHSA came together to launch the Blending Initiative, which featured regular Blending Conferences, a greater focus on interactions with single state agency directors to help facilitate broader adoption of research-supported treatment, and the development of Blending Teams and Blending Products to operationalize implementation of research findings in the field. A description of each of the currently available Blending Products is provided, as well as an introduction to two new Blending Products coming soon. Research on the CTN’s impact in the adoption of new evidence-based practices is also presented, along with a showcase of resources those interested in implementation might find useful on the NIDA CTN web site, the online CTN Dissemination Library, and the CTN Datashare page.
Researchers involved in the CTN protocols NIDA-CTN-0006 and NIDA-CTN-0007 (Motivational Incentives for Enhanced Drug Abuse Recovery in Drug Free Clinics and Methadone Clinics) have shown that motivational incentive programs using low-cost reinforcement (prizes, vouchers, clinic privileges, etc.), delivered in conjunction with onsite urine screening promotes higher rates of treatment retention and abstinence from drug abuse. This Blending Team product focuses on informing the field about successful approaches in the use of motivational incentives (also referred to as contingency management). The package includes an instructional CD-ROM, loaded with a video featuring conversations from top researchers to clinicians to patients in the field of addiction and recovery; sample documents that are customizable to your needs; PowerPoint presentations; research articles; and various additional resources. The PAMI Product was distributed to Research Utilization Committee (RUC) members in May 2007. It can also be downloaded from the ATTC web site.
This product was updated in 2011, providing tools designed to build awareness of Motivational Incentives as an effective therapeutic strategy within the addiction treatment field. It has been combined with two other MI Blending Team Products, MI:PRESTO and MIIS, to form a “Motivational Incentives (MI) Package.” MIIS has been discontinued; the other two products can be found here: https://collaborativeforhealth.org/bettertxoutcomes/.
Related protocols: CTN-0006, CTN-0007
This presentation begins with an overview of the two CTN MIEDAR projects, which examined the use of a low-cost incentive program to increase abstinence rates among patients in both methadone and drug-free substance abuse treatment programs. The studies showed that patients assigned to the incentive program remained in treatment longer and submitted a greater percentage of substance-free urine samples than patients in usual care, in both types of community treatment programs. Because of the positive outcomes of these two trials, NIDA and SAMHSA adapted the protocol for the Blending Team Product, “Promoting Awareness of Motivational Incentives” (PAMI), the materials for which are all available in both the CTN Dissemination Library.
The presentation concludes with a series of suggested “next steps” for clinicians looking for more help on how to implement incentives in their own treatment programs. A second MIEDAR Blending Team Product is currently being developed; it will take advantage of modern technology by offering computer-based trainings and implementation support. Watch for this product to be released as early as Spring 2011.
Related protocols: CTN-0006, CTN-0007
This 12-page brochure provides an overview of the first decade of research in the National Drug Abuse Treatment Clinical Trials Network. The CTN was started in 1999 to help bridge the gap between research and practice in the drug and alcohol abuse field, helping move evidence-based treatments into adoption in community treatment centers. The CTN’s innovative approach blends the skills and experience of community treatment providers and academic researchers in collaborative partnerships (“Nodes”) that offer patients better access to scientifically tested treatments. In the first 10 years, the CTN has fueled a cultural shift toward evidence-based care for substance abuse treatment, showing that rigorous and relevant clinical research can be carried out directly in CTPs and can address a broad range of addictive disorders. Some of the most effective protocols include those about buprenorphine, a pharmacotherapy for opiate addiction; contingency management/motivational incentives; and motivational interviewing.
The brochure also describes several CTN-related projects, such as the NIDA/SAMHSA Blending Initiative, which has developed several products to assist in the dissemination and training for some of the CTN’s successful treatment protocols, and the CTN Dissemination Library, which is a digital repository of resources and downloadable materials by and about the CTN. The CTN will continue to evolve and is poised to examine a variety of innovative approaches in its next decade, all with the ultimate goal of getting the best treatments to those who need them.
This presentation begins with an overview of the history of dissemination-focused committees in the CTN, beginning with the Dissemination Subcommittee, started in 2001, which over time has evolved into the present-day Research Utilization Committee (RUC). During the first decade of the CTN, several dissemination and implementation strategies have been employed, including the publication of numerous articles about technology transfer, platform dissemination/implementation studies, NIDA-SAMHSA Blending Team Products and Blending Conferences, and a variety of regional dissemination workshops, local trainings, and interactive websites.
Additionally, the CTN Dissemination Library was launched in 2003 to provide CTN members and the public with a single point of access to research findings and other materials approved for dissemination throughout the CTN and to the larger community of providers, researchers, and policy-makers. Use of the Blending Products, trainings and workshops, and the Library have grown steadily in the past several years. The presentation ends with suggestions for ways the RUC can continue to help “close the gap” between treatment and research.
The Buprenorphine Treatment for Young Adults Blending Team designed a training package which highlights the findings of protocol CTN-0010, “Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents/Young Adults,” which compared longer-term versus short-term buprenorphine/naloxone treatment in an outpatient setting.
The 3-hour training program examines the prevalence of and treatment admission rates for nonmedical use of opioids among young adults; provides an overview of opioid use among young adults; explores and increases understanding of the results of new research on using buprenorphine to treat opioid addiction in young adults; and describes the implications of these findings for the treatment of opioid addiction in young adults.
Related protocols: CTN-0010