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
Objective: This secondary analysis evaluated the validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool for older adults.
Methods: Researchers performed a subgroup analysis of older adults aged =65 (n = 184) from the TAPS tool validation study conducted in 5 primary care clinics (CTN-0059). They compared the interviewer and self-administered versions of the TAPS tool at a cutoff of =1 for identifying problem use with a reference standard measure, the modified World Mental Health Composite International Diagnostic Interview.
Results: The mean age was 70.6 ± 5.9 years, 52.7% were female, and 49.5% were non-Hispanic Black. For identifying problem use, the self-administered TAPS tool had sensitivity of 0.91 (95% CI: 0.75–0.98) and specificity of 0.91 (95% CI: 0.85–0.95) for tobacco; sensitivity of 0.68 (95% CI: 0.45–0.86) and specificity of 0.88 (95% CI: 0.82–0.93) for alcohol; and sensitivity 0.86 (95% CI: 0.42–1.00) and specificity 0.94 (95% CI: 0.90–0.97) for cannabis. The interviewer-administered TAPS tool had similar results. Researchers were unable to evaluate its performance for identifying problem use of individual classes of drugs other than cannabis in this population due to small sample sizes.
Conclusions: While the TAPS had excellent sensitivity and specificity for identifying tobacco use among older adults, the results for other substances lack precision, and we were unable to evaluate its performance for prescription medications and individual illicit drugs in this sample. This analysis underlines the critical need to adapt and validate screening tools for unhealthy substance use, specifically for older populations who have unique risks.
Related protocols: CTN-0059
Strategies are needed to identify at-risk patients for adverse events associated with prescription opioids. This study identified prescription opioid misuse in an integrated health system using electronic health record (EHR) data, and examined predictors of misuse and overdose.
The sample included patients from an EHR-based registry of adults who used prescription opioids in 2011 in Kaiser Permanente Northern California, a large integrated health care system. Researchers characterized time-at-risk for opioid misuse and overdose, and used Cox proportional hazard models to model predictors of these events from 2011 to 2014.
Results found that among 396,452 patients, 2.7% were identified with opioid misuse and 1044 had an overdose event. Older patients were less likely to meet misuse criteria or have an overdose. Whites were more likely to be identified with misuse, but not to have an overdose. Alcohol and drug disorders were related to higher risk of misuse and overdose, with the exception that marijuana disorder was not related to opioid misuse. Higher daily opioid dosages and benzodiazepine use increased the risk of both opioid misuse and overdose.
Conclusions: EHR data can be used to identify several risk factors associated with misuse and overdose, including comorbidities and benzodiazepine use, critical information for identifying at-risk patients. Findings can inform targeted patient screening and intervention, prescribing of medications such as buprenorphine for opioid dependence or naloxone for opioid reversal, disease management approaches for this patient population, and guide appropriate opioid prescribing policies which are becoming increasingly conservative and risk being applied without an individualized approach.
Related protocols: CTN-0061-Ot
Emerging adults (roughly 18-29 years) with substance use disorders can benefit from participation in twelve-step mutual-help organizations (TSMHO), however, their attendance and participation in such groups is relatively low. Twelve-step facilitation therapies, such as the Stimulant Abuser Groups to Engage in 12-Step (STAGE-12), may increase attendance and involvement, and lead to decreased substance use.
This study used data from the NIDA Clinical Trials Network STAGE-12 protocol (CTN-0031), a multisite randomized controlled trial, to examine whether age moderated the STAGE-12 effects on substance use and TSMHO meeting attendance and participation, The original STAGE-12 study involved assessments at baseline, mid-treatment (week 4), end-of-treatment (week 8), and 3- and 6-months post-randomization; participants were adults with DSM-IV diagnosed stimulant abuse or dependence (N=450) enrolling in 10 intensive outpatient substance use treatment programs across the U.S. A zero-inflated negative binomial random-effects regression model was utilized to examine age-by-treatment interactions on substance use and meeting attendance and involvement.
Analyses found that younger age was associated with larger treatment effects for stimulant use. Specifically, younger age was associated with greater odds of remaining abstinent from stimulants in STAGE-12 versus Treatment-as-Usual; however, among those who were not abstinent during treatment, younger age was related to greater rates of stimulant use at follow-up for those in STAGE-12 compared to TAU. There was no main effect of age on stimulant use. Younger age was also related to somewhat greater active involvement in different types of TSMHO activities among those in STAGE-12 versus TAU. There were no age-by-treatment interactions for other types of substance use or for treatment attendance, however, in contrast to stimulant use; younger age was associated with lower odds of abstinence from non-stimulant drugs at follow-up, regardless of treatment condition.
Conclusions: These results suggest that STAGE-12 can be beneficial for some emerging adults with stimulant use disorder, and ongoing assessment of continued use is of particular importance. More targeted research addressing the differences between younger and older adults and their unique responses to treatment is needed, so that developmental variations can be considered in the provision of substance abuse treatment. Age-appropriate treatment could have considerable effects on clinical outcomes and public health.
Related protocols: CTN-0031
The use of prescription opioids has increased dramatically in the past 2 decades, with associated increases in opioid misuse/abuse and opioid overdose. These are among the most commonly prescribed medications, with 259 million prescriptions written for opioid pain relievers in the U.S. in 2012.
This study aimed to establish a prescription opioid registry protocol in a large health system, Kaiser Permanente Northern California (KPNC), and to describe algorithms to characterize individuals using prescription opioids, opioid use episodes, and concurrent use of sedative/hypnotics.
Using KPNC electronic health record data, the investigators selected patients using prescription opioids in 2011. Opioid and sedative/hypnotic fills, and physical and psychiatric comorbidity diagnoses were extracted for years 2008 to 2014. Algorithms were developed to identify each patient’s daily opioid and sedative/hypnotic use, and morphine daily-dose equivalent. Opioid episodes were classified as long-term, episodic, or acute. Logistic regression was used to predict characteristics associated with becoming a long-term opioid user.
Results found that in 2011, 18% of KPNC adult members filled at least 1 opioid prescription. Among those patients, 25% used opioids long term and their average duration of use was more than 4 years. Sedative/hypnotics were used by 76% of long-term users. Being older, white, living in a more deprived neighborhood, having a chronic pain diagnosis, and use of sedative/hypnotics were predictors of initiating long-term opioid use.
Conclusions: This study established a population-based opioid registry that is flexible and can be used to address important questions of prescription opioid use. It will be used in future studies to answer a broad range of other critical public health issues relating to prescription opioid use.
Related protocols: CTN-0061-Ot
Already the most commonly used illicit drug worldwide, cannabis continues to rise in popularity as the perception of its harmfulness decreases and evidence of its deleterious developmental effect increases. While internalizing distress and suicide risk have been linked with cannabis use problems (DSM-5 cannabis use disorder (CUD); DSM-IV cannabis abuse and dependence) it remains unclear how this association varies over the course of development in treatment-seeking men and women.
The current study utilized the NIDA Clinical Trials Network (CTN) to conduct a cross-sectional comparison of internalizing distress and suicide risk among men (n=437) and women (n=163) spanning ages 18-50 who met DSM-5 criteria for CUD (the sample was comprised of participants who had been screened for participation in CTN-0053). Interactions between gender and developmental stage (i.e., late adolescent, early adulthood, and middle adulthood) were observed for suicide risk and anxiety but not depression problems. Specifically, women seeking CUD treatment in late adolescence and middle adulthood exhibited significantly higher rates of anxiety and suicide risk compared to men seeking treatment during the same developmental stage. Internalizing distress and suicide risk did not differ between treatment-seeking men and women in the early adult stage.
Conclusions: This study is the first to utilize a gender differences framework to estimate how concurrent psychosocial problems associated with CUD may be moderated by development stage in those presenting for care. Results suggest that the structure of risk for CUD may differ in men and women across the lifespan and that women presenting for CUD treatment during late adolescence and middle adulthood may uniquely benefit from intervention designed to address these elevations in anxiety and suicide risk.
Related protocols: CTN-0053
Although prescription opioid use disorder has recently increased sharply in the United States, relatively little is known about the general well-being of this population. Assessment of quality of life in patients with substance use disorders has been recommended to improve clinical care. In this study, health-related quality of life was examined in prescription opioid-dependent patients at entry to the National Drug Abuse Treatment Clinical Trials Network’s “Prescription Opiate Addiction Treatment Study (POATS)”, a national multi-site trial, to compare quality of life scores in the study sample to other populations. Background variables associated with quality of life in the literature were also examined.
Prescription opioid-dependent patients (N=653) were compared to general populations on the Medical Outcome Study Short Form-36 (SF-36) quality of life measure, and the association between patient background variables and quality of life was examined. Compared to a general population, the current sample of prescription opioid-dependent patients had worse physical and mental quality of life as measured by the SF-36, similar to other opioid-use disorder populations. Within this sample, women showed more impairment than men in mental quality of life, while older patients scored worse on physical, but not mental, quality of life. Chronic pain was associated with poorer physical quality of life.
Conclusions: The growing focus on wellness underscores the importance of measuring quality of life in addition to substance use outcomes. Routine assessment of health-related quality of life can add an important dimension to overall evaluation of patients’ treatment response. Furthermore, brief, widely-used measures of health-related quality of life such as the SF-36 enable comparisons of these factors between different patient populations and can inform both clinical treatment selection and policy decisions about the allocation of health care resources.
Related protocols: CTN-0030
This workshop, led by Carmen Rosa of NIDA’s Center for the Clinical Trials Network, featured three presentations focused on the use of various types of new media in the design and conduct of clinical trials. Over 82% of adults now use internet or email, including 53% of those age 65 and older. Additionally, 67% of online adults use social networking sites. Mobile devices such as smartphones, tablets, netbooks, and laptops are now a primary source of Internet connectivity, and 79% of cell phone owners say they use text messaging. As use of these tools continues to grow, exploring ways to put them to use in clinical trials seems increasingly relevant.
The first presentation, by Erin Winstanley, “Using New Media Tools in the Design and Conduct of Clinical Trials,” provided an overview of the concept of “new media” and ways it can be applied to research, including advertising of studies, recruiting/tracking participants, communicating with participants, and disseminating research findings. An introduction to Facebook and Twitter is provided, as well as a look at the use of blogs, Pinterest, and LinkedIn.
Gloria Miele presented on “Social Media Communication Strategy,” giving participants a look at ways to think about and draft policies regarding the use of social media in your study or workplace. A variety of legal considerations, as well as examples of using social media to recruit study participants is also provided. Sample IRB guidance is included, along with IRB Best Practices for using new media. The presentation ends with a case study based on CTN-0044 (“Web Delivery of Evidence-Based, Psychosocial Treatment for Substance Use Disorders”), which used social media platforms like Facebook, as well as email and texting, to contact and follow-up with participants.
The third presentation, by Lynn Simpson, was a demonstration of the variety of uses for “REDCap, Research Electronic Data Capture, A Data Management and Survey Tool.” REDCap is a web-based application designed to give researchers and clinicians the capacity to create and manage databases and surveys in order to support data capture for research.
Related protocols: CTN-0044
Since stimulant use disorders (SUDs) remain prevalent across the lifespan, cognition is an important area of clinical care and research focus among aging adults with SUDs. This secondary analysis of data from the National Drug Abuse Treatment Clinical Trials Network (CTN) study “Stimulant Abuser Groups to Engage in 12-Step (STAGE-12),” protocol CTN-0031, suggests that decision-making, verbal learning/memory, executive function, and set shifting are important cognitive domains to screen clinically and treat in aging adults with SUDs. Some suggestions are made on how clinical treatment providers can use these results in a practical way. A neurocognitive assessment might be considered standard at initial and periodic follow-up visits. Providers might also consider adding adjunctive treatments in patient treatment plans to directly remediate impaired cognitive domains (e.g., decision-making, executive function). Finally, by capitalizing on unimpaired cognitive domains, treatment providers might modify their treatment approach to compensate for impaired domains — for example, instead of totally relying on verbal modalities, a provider might also consider using a visual one (e.g., pictures, white board, computer screen) to convey information and compensate for a patient’s impairment in verbal learning/memory. Future directions include potentially conducting pre/post neuroimaging of frontal cortical regions in aging adults with SUDs, correlating neuroimaging findings with neurocognitive measures in aging adults with SUDs, and developing cognitively remediating treatments (pharmacological and/or non-pharmacological) specific to affected cognitive domains (e.g., decision-making, verbal learning/memory, executive function, set shifting) in aging adults with SUDs.
Related protocols: CTN-0031-A-1