Search the Library

Authentic community engagement requires partnership with those who share similar situations, concerns, or challenges. Community engagement in research can promote equitable representation, help inform important research questions and deliverables, and increase the likelihood of developing relevant and appropriate interventions that will be implemented and sustained. Established in 1999, the National Drug Abuse Treatment Clinical Trials Network (CTN) is a cooperative agreement within the National Institute on Drug Abuse (NIDA) and functions as a nationwide consortium of research scientists, treatment providers and other community members collaborating to improve care for substance use in communities across the US. The CTN is committed to community-engaged research. Developed in 2023, the CTN Community Representative Council (CIRCL) formed as a natural progression of this commitment, designed to systematically identify front line challenges warranting research and to recognize emerging community-based innovations – forms of “practice-based evidence” developed in response to real-world needs. CTN Nodes (regional hubs) nominated community members, many of whom are people with lived experience (PWLE) of substance use to serve as Council representatives to enhance the identification, communication, and dissemination of the needs and experiences of individuals served by CTN research across the US. This commentary provides an overview of CIRCL’s conceptualization and creation, operation, and impacts on CTN communities in its first year.

This presentation describes a program of research focused on increasing the uptake of effective services for youth with or at risk of substance use disorders. The presentation introduces both patient-focused dissemination (e.g., technology-assisted interventions, direct-to-consumer marketing) and provider- and organization-focused (e.g., multi-level implementation strategy) strategies. Fundamentals of dissemination and implementation science, as well as priorities for future research, are also discussed.

Download slides

This newsletter, published monthly by the Greater Intermountain Node, reports on current studies in the node, work by node members, research opportunities, and other information of interest to node participants and the broader CTN community.

Subscribe to the newsletter and find archived issues here!

Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States NIDA Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings.

A technology transfer model was implemented and ran from 2011-2013. The Florida Node Alliance shared the “know how” for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.

Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians.

Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimentional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, “Seeking Safety,” and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles.

Conclusions: As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge their receipt of training.

This Blending Team Product combines a CME course and Patient Simulation to create a unique forum to provide practical guidance for physicians and other clinicians in effective Motivational Interviewing techniques that will facilitate conversations with patients to address health risk behaviors. The CME course, “Talking to Patients about Health Risk Behaviors,” guides physicians, nurses, and other clinicians through practical skills building and technique development using videos to model effective communication, while the interactive Patient Simulation allows for real time testing and reinforcement of these skills in the clinical setting.

Physicians can earn a maximum of 1.5 AMA PRA Category 1 Credits via the CME course; Nurses can earn 1.5 ANCC Contact Hours. There is also an unaccredited module for other providers to use to enrich their clinical best practices.

This NIDA/SAMHSA Blending Team Product is an online resource hub providing information and tools related to a variety of technology-assisted care for substance use disorders. Technology-assisted care is a rapidly evolving field focused on adding technology-based elements to a practitioner’s “toolkit” as a supplement and complement to their treatment repertoire. These elements take many forms and formats, including audio, video, animations, and/or other forms of multimedia. It also may use information from medical records or physiological data capture devices, and may be interactively customized or tailored to an individual user’s needs. Treatment practices administered via technology-based interventions include: Cognitive Behavioral Therapy; Community Reinforcement Approach (CRA); Contingency Management; Motivational Enhancement; Motivational Interviewing; and Screening, Brief Intervention and Relapse Prevention.

The SUDTECH site is a collaborative product providing information, videos, training, and other resource information for implementing technology assisted treatments/care to improve the quality and reach of treatment services for persons with substance use disorders. It includes curricula, research studies and links, video interviews with practitioners who use technology-assisted care, information on administrative and other considerations for implementing this type of approach, program models, and much more.

SUDTECH focuses primarily on two technology-assisted care models: Therapeutic Education System (TES) and Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT). A National Drug Abuse Treatment Clinical Trials Network protocol evaluated the effectiveness of TES (CTN-0044), a web-based psychosocial intervention for substance use disorder, and found that it doubled the odds of abstinence among clients who tested positive for substances, improved retention, and suggested that TES could be effectively substituted for a portion of face-to-face counseling and produce better outcomes. CBT4CBT is a web-based program that teaches a variety of skills to help people reduce their substance use. While not studied in the CTN, a randomized controlled trial of 77 individuals seeking outpatient treatment found that participants assigned to CBT4CBT submitted significantly more urine specimens testing negative for any type of drugs, especially cocaine, and tended to have longer continuous periods of abstinence during treatment.

Related protocols: CTN-0044

Rates of adoption of evidenced-based practices to treat opioid dependence, including the use of medications, are low and severely limit secondary prevention efforts to curtail the prescription drug epidemic. The goal of this article was to describe how involvement in a research clinical trials network, the National Drug Abuse Treatment Clinical Trials Network (CTN), facilitated the adoption of medications to treat opioid dependence at two community-based treatment programs (CTPs) affiliated with the Ohio Valley Node (OVN) of the network. Both programs are large, not-for-profit facilities that treat patients with either public or private insurance. One program, Maryhaven, had limited experience using FDA-approved medications to treat opioid dependence before joining the CTN; the other, Midtown, had a methadone clinic but no experience with buprenorphine or naltrexone. This article discusses the adoption of medications to treat opioid dependence in these two programs by highlighting critical turning points, lessons learned, and challenges encountered.

Conclusions: The NIDA CTN is a research network that facilitates the adoption of innovative science-based treatments for SUDs. One of the intrinsic values of participating in a research network is that the infrastructure allows opportunities for collaborative relationships to develop, building trust over time, and ultimately providing a professional network that can provide technical assistance that may be the final barrier to adoption or serve as a tipping point for adoption. Participation in a clinical trials network may facilitate adoption by providing the infrastructure for trialability and observability, but the most critical function may be the knowledge translation that occurs through the individual-level professional relationships that develop.

This presentation provides an overview of the organization, mission, and history of NIDA’s National Drug Abuse Treatment Clinical Trials Network (CTN) in New England, including clinical research trials completed by New England programs participating in the CTN. The CTN was developed partially in response to a 1998 Institute of Medicine Report that spoke of the “serious gaps of communication” between the research community and community-based drug treatment programs. There is also a gap between social work research and practice in the addictions, with one national study of MSW degree programs finding that only 14.3% of accredited schools offered specializations in addiction. The CTN is a partnership between academic research centers and community drug abuse treatment programs, with the aim of developing and implementing multi-site clinical research studies and supporting the dissemination and adoption of any evidence-based interventions that result.

The CTN in New England began with two nodes in 2002 — the Northern New England Node (with a Regional Research Training Center (RRTC) at McLean Hospital/Harvard) and the New England Node (RRTC at Yale). In 2010 (through the present), those two nodes were combined to form the New England Consortium Node (with McLean and Yale serving as co-RRTCs). The New England node(s) have participated in 9 protocols (as well as the 2 additional baseline studies all CTN organizations participated in), between 2002-2013. Aims and outcomes from those studies are presented, followed by a brief introduction to some of the new studies currently being launched in the network.

CTN studies can also be used as a model to test interventions relevant to social work, such as sexual risk reduction skills training. Social workers are involved in the CTN, serving as study principal investigators, executive directors in treatment programs, program managers, counselors, and research assistants. The CTN is a valuable mechanism for training social workers in the delivery of empirically-supported treatments and counseling styles, and can also serve as a training platform for future careers in the field. Social workers can — and do! — play a vital role in helping to bridge the gap between research and treatment in the substance abuse field.

The Affordable Care Act calls for integration of substance abuse treatment into medical care via medical homes and continuing specialty care. For this integration to occur in the substance abuse treatment field, substantial sharing and dissemination of information by treatment providers is required. This study explored the determinants of organizational activities directed at disseminating evidence-based practices (EBPs) undertaken by 193 community treatment programs who are members of the National Institute on Drug Abuse’s National Drug Abuse Treatment Clinical Trials Network (CTN). Using factor analysis, the research identified two generic categories reflecting different motivations for dissemination activities and explored both treatment center leadership and organizational characteristics as determinants of these different types of dissemination activities. Organizational characteristics predicting treatment center dissemination activities included size, previous involvement in research protocols, linkages with other providers, and having non-profit status. The treatment center leader’s membership in professional organizations was also a significant determinant. Organization variables account for a larger portion of the variance in treatment center dissemination activities.

Conclusions: The results suggest that the willingness of treatment providers to help disseminate EBPs within the industry may be heavily influenced through shared network connections with other treatment organizations. Policy leaders’ efforts to increase EBP implementation and care integration targeted by the ACA may want to pay particular attention to the effects of network involvement found in this study.

This presentation describes the CTN, provides an overview of its work, and highlights the applicability of its findings to social work research and practice. It focuses particularly on CTN studies conducted in the New England Node, and identifies linkages between clinical research, empirically-supported treatments, and social work practice in addictions.

There are many benefits of data sharing, including the promotion of new research from effective use of existing data, replication of findings through re-analysis of pooled data files, meta-analysis using individual patient data, and reinforcement of open scientific inquiry. A randomized controlled trial is considered the “gold standard” for establishing treatment effectiveness, but clinical trial research is very costly — sharing data is an opportunity to expand the investment of the clinical trial beyond its original goals at minimal cost. This article describes the goals, developments, and usage of the Data Share website for the National Drug Abuse Treatment Clinical Trials Network (CTN) in the U.S., including lessons learned, limitations, and major revisions, and considerations for future directions to improve data sharing. Since its inception in 2006 and through October 2012, nearly 1700 downloads from 27 clinical trials have been accessed from the Data Share website, with use increasing over the years. Individuals from 31 countries have downloaded data from the site, and there have been at least 13 publications derived from analysis of data obtained through the public Data Share website. Limitations of the website include minimal control over data requests and usage, which has resulted in little information and lack of control regarding how the data from the website are being used, and a lack of uniformity in data elements collected across CTN trials, which has limited cross-study analyses.

Conclusions: The Data Share website offers researchers easy access to de-identified data files with the goal to promote additional research and identify new findings from completed CTN studies. To maximize the utility of the website, ongoing collaborative efforts are needed to standardize the core measures used for data collection in the CTN studies with the goal of increasing their comparability and facilitating the ability to pool data files for cross-study analyses.

Supported by the Duke Clinical Research Institute (CTN DSC 1).

The National Drug Abuse Treatment Clinical Trials Network (CTN) is a practice-based research network that partners academic researchers with community based substance use disorder (SUD) treatment programs designed primarily to conduct effectiveness trials of promising interventions. A secondary goal of the CTN is to widely disseminate results of these trials and thus improve the quality of SUD treatment in the U.S. Drawing on data from 156 CTN programs, this study examined the associated between involvement in CTN protocols and overall treatment quality measured by a comprehensive index of 35 treatment services. Negative binomial regression models show that treatment programs participating in a greater number of CTN protocols had significantly higher levels of treatment quality, an association that held after controlling for key organizational characteristics. Given that protocol participation was positively associated with quality of treatment, the question remains about how to successfully translate this knowledge and skill base to community-based treatment programs that are not directly involved in clinical research. The CTN has undertaken a number of dissemination initiatives to do just that, including the NIDA/SAMHSA Blending Initiative and the CTN Dissemination Library, though there have been few studies examining the direct impact of these dissemination activities on the quality of treatment services within and outside the CTN.

Conclusions: At their core, practice-based research networks, such as the CTN, offer community based clinicians the opportunity to bring innovation to and to address problems encountered in everyday treatment practice. They also provide an opportunity to identify barriers to implementation and to tailor implementation strategies to meet the real world needs of community-based treatment programs. However there are significant strides to be made in disseminating knowledge, skills, and training to programs that do not actively participate in clinical research in the wider treatment community. These findings contribute to the growing body of research on the role of practice-based research networks in promoting health care quality.

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 one-day conference was designed to benefit front-line clinical staff delivering addiction treatments in Texas. Speakers presented sessions in the morning on Motivational Interviewing (MI) with a focus on shifting talk to action, an introduction to Acceptance and Commitment Therapy (ACT) and review of its effectiveness, and a review of pharmacological treatments for addictive disorders. Afternoon breakout sessions for MI and ACT expanded upon information discussed in the morning sessions and attendees engaged in experiential learning and practice.

View conference agenda.

Presentations:

Advanced Motivational Interviewing: Shifting from Talk to Action, Scott Walters, PhD

An Introduction to Acceptance and Commitment Therapy (ACT) with a Focus on Opioid Dependent Patients (morning session | afternoon session), Angela Stotts, PhD.

Pharmacotherapy for Addictive Disorders, Sidarth Wakhlu, MD