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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.
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.
Addiction is a chronic brain disease with consequences that remain problematic years after discontinuation of use. Despite this, treatment models focus on acute interventions and are carved out from the main health care system. The Patient Protection and Affordable Care Act (2010) brings the opportunity to change the way substance use disorder (SUD) is treated in the United States. The treatment of SUD must adapt to a chronic care model offered in an integrated care system that screens for at-risk patients and includes services needed to prevent relapses. The partnering of the health care system with substance abuse treatment programs could dramatically expand the benefits of prevention and treatment of SUD. Screening, Brief Intervention, and Referral to Treatment (SBIRT), the subject of National Drug Abuse Treatment Clinical Trials Network protocols CTN-0047 (SMART-ED) and CTN-0057-Ot (SBIRT-PC), is cited as an effective strategy in identifying and intervening drug problems in emergency departments and primary care and improving health outcomes. Expanding roles of health information technology and nonphysician workforces, such as social workers, are essential to the success of a chronic care model.
This article by the Director of the Center for the Clinical Trials Network (CCTN, Dr. Tai) and the Director of the National Institute on Drug Abuse (NIDA, Dr. Volkow) is part of a special issue of the journal Social Work in Public Health about “The Role of Social Work in the Prevention and Treatment of Substance Use Disorders” that includes a number of articles about the National Drug Abuse Treatment Clinical Trials Network (CTN). See [*URL*] for more information about the issue.
Related protocols: CTN-0047, CTN-0057-Ot
The changing ethnic composition of the nation and increasing requirements to use evidence-based treatments (EBTs) challenge mental health professionals to adapt treatments and interventions to be appropriate for their clients. This article applies the available information on cultural adaptation to substance abuse. The most common approaches for adapting substance use interventions include some combination of either community involvement in the adaptation, existing research and literature, and/or consultation from experts to adapt EBTs. As an example of the process used to develop a culturally-adapted intervention, research stemming from National Drug Abuse Treatment Clinical Trials Network protocol CTN-0018 (Reducing HIV/STD Risk Behaviors: A Research Study for Men in Drug Abuse Treatment) is described.
This project found that the Real Men Are Safe (REMAS) protocol was less effective for black male substance users than for whites, leading the research team to develop a culturally adapted version of the intervention. After addressing the sociocultural factors associated with HIV risk behaviors among ethnic minority males abusing substances, the resulting REMAS-CA intervention (Real Men Are Safe – Culturally Adapted) was found to be more effective than the original in reducing HIV risk behaviors in black and Hispanic men. The challenges facing the development of culturally adapted interventions include the need for additional research to determine which specific EBTs warrant adaptation, the responsibility of maintaining the balance between fidelity and adaptation, and the challenge of intragroup diversity.
Related protocols: CTN-0018
Social workers are often on the front lines of the HIV/AIDS epidemic delivering prevention education and interventions, offering or linking individuals to HIV testing, and working to improve treatment access, retention, and adherence, especially among vulnerable populations. Individuals with substance use disorders face additional challenges to reducing sexual and drug risk behaviors, as well as barriers to testing, treatment, and antiretroviral therapy adherence.
This article presents current data on HIV transmission and research evidence on prevention and interventions with substance abusers, and highlights how individual social workers can take advantage of this knowledge in practice and through adoption and implementation with organizations. Research from the National Drug Abuse Treatment Clinical Trials Network (CTN) about rapid HIV testing and gender-specific HIV risk reduction interventions is described.
Related protocols: CTN-0018, CTN-0019, CTN-0032
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.