Longitudinal Assessment of a Manualized Group Treatment Program for Gambling Disorder: The Ohio Problem Gambling Treatment Model for Adults with Co-Occurring Disorders.

Individuals with gambling disorder (GD) experience a host of negative psychosocial and physical health outcomes, yet few seek treatment. Of particular concern are individuals with co-occurring mental and behavioral health disorders, a group at higher risk for GD in the state of Ohio. To better serve this population, the Ohio Department of Mental Health and Addiction Services developed a group-based GD treatment manual for adults with co-occurring disorders. Over the course of 5 years, 353 individuals engaged in at least some of the manual's 12 weekly modules, and more than one-third (n = 122) completed the entire curriculum. Participants who completed all 12 modules completed pre-and post-tests, and after controlling for covariates, participants significantly decreased their GD symptom severity, though changes in self-esteem and gambling urges were non-significant. These findings suggest the treatment manual holds promise at reducing gambling behaviors for individuals with co-occurring disorders, but further research is warranted to explore best practices on how to intervene on the psychological antecedents to gambling in this population.

Gender differences in patient outcomes following drug abuse treatment in Afghanistan: Results from a new evaluation.

Drug use rates among adults in Afghanistan are over twice as high as the global average which complicates an already challenging situation in the country. Although progress has been made toward improving availability of treatment and the rights and status of women, cultural norms and historical precedents have delayed advances, including in drug treatment. Female Afghan patients access treatment via home-based systems without the option of group in-patient treatment centers available to male patients. Using data from a new evaluation of Afghanistan's drug treatment system we report on updated differences in treatment outcomes for male and female patients in drug treatment centers in Afghanistan. A probability sample was used, selecting 32 centers to evaluate, and including baseline and follow-up data from 865 individuals who were officially admitted to drug treatment. Data collection included: (a) baseline and follow-up interviews; (b) baseline and follow-up urine drug tests; and (c) intake and treatment participation records. Random intercept generalized linear models were used to analyze change by regressing outcomes on a contrast representing time and a correction for selectivity biases. Male and female patients had similar, overall pre-treatment characteristics including low levels of education, though education levels were lower for women. At follow-up, there were significant differences between male and female patients' self-reports of substance use and related consequences, including criminal behavior. These findings represent mixed results; while some progress has been made in offsetting gender disparities in Afghanistan, remaining significant gender differences in posttreatment results suggest more positive outcomes for female than for male patients.

With crisis comes opportunity: Unanticipated benefits resulting from pivots to take-home naloxone (THN) programs during the COVID-19 pandemic.

The COVID-19 pandemic resulted in stay-at-home orders, which presented a significant challenge to the design and operation of an essential harm-reduction strategy in the opioid epidemic: community-based, take-home naloxone (THN) programs. This commentary describes how four rural and/or Appalachian communities quickly pivoted their existing THN programs to respond to community need. These pivots, which reflect both the context of each community and the capacities of its service delivery and technology platforms, resulted in enhancements to THN training and distribution that have maintained or expanded the reach of their efforts. Additionally, all four community pivots are both highly sustainable and transferrable to other communities planning to or currently implementing THN training and distribution programs.

If momma ain't happy with the mentoring relationship, ain't nobody happy with the mentoring relationship: Parental satisfaction as a predictor of mentoring match strength and length.

Much evidence exists on whether an individual's perception of a match relationship impacts match strength and length, but relatively less is known about whether parental perceptions of the match (i.e., whether the match is meeting their goals) impacts the length and strength of mentoring relationships. These relationships were examined in a sample of 350 newly formed youth-mentor matches who completed multiple measures of match strength and satisfaction with the match. Parents/guardians were also surveyed about their level of satisfaction with the match. The primary finding of this paper was that parent/guardian dissatisfaction with the match relationships meeting goals was the only significant predictor of a higher likelihood of match closure. Although youth and mentor self-reports of satisfaction with how match time was spent were the strongest predictors of volunteer and youth match strength ratings, parent/guardian satisfaction with the match relationship also remained a strong predictor of match strength. The implications of these findings are discussed.

Drug use and treatment success among gang and non-gang members in El Salvador: a prospective cohort study.

BACKGROUND: This article focuses on examining drug abuse treatment (DAT) in El Salvador highlighting gang vs. non-gang membership differences in drug use and treatment outcomes. METHODS: Cross-sectional and prospective cohort designs were employed to examine the study aims. The 19 centers that met the study's inclusion criteria of one year or less in planned treatment offered varying treatment services: individual, group, family, and vocational therapy, dual diagnosis treatment, psychological testing, 12-step program, and outreach and re-entry aftercare. Most directors describe their treatment approach as "spiritual." Data were collected from 625 patients, directors, and staff from the 19 centers at baseline, of which 34 patients were former gang members. Seventy-two percent (72%) of the former patients (448) were re-interviewed six-months after leaving treatment and 48% were randomly tested for drug use. RESULTS: Eighty-nine percent (89%) of the DAT patients at baseline were classified as heavy alcohol users and 40% were using illegal drugs, i.e., crack, marijuana, cocaine, tranquilizers, opiates, and amphetamines. There were large decreases after treatment in heavy alcohol and illegal drug use, crime, and gang related risk activities. Gang members reported illegal drug use, crime, and gang related risk activity more than non-gang members, yet only 5% of the study participants were gang members; further, positive change in treatment outcomes among gang members were the same or larger as compared to non-gang members. CONCLUSIONS: Alcohol use is the drug of choice among DAT patients in El Salvador with gang member patients having used illegal drugs more than non-gang members. The study shows that DAT centers successfully reduced the use of illegal drugs and alcohol among gang and non-gang members. Although our study could not include a control group, we believe that the DAT treatment centers in El Salvador contributed to producing this treatment success among former patients. These efforts should be continued and complemented by funding support from the Salvadoran government for DAT centers that obtain certification. In addition, tailored/alternative treatment modalities are needed for gang members in treatment for heavy drinking.

The impact of active consent procedures on nonresponse and nonresponse error in youth survey data: evidence from a new experiment.

This article reports results from a student survey fielded using an experimental design with 14 Kentucky school districts. Seven of the 14 districts were randomly assigned to implement the survey with active consent procedures; the other seven districts implemented the survey with passive consent procedures. We used our experimental design to investigate the impact of consent procedures on (a) participation rates, (b) demographic characteristic of the survey samples, and (c) estimates of alcohol, tobacco, and other drugs (ATOD) use. We found that the use of active consent procedures resulted in reduced response rates, underrepresentation of male students and older students, and lower lifetime and past 30-day prevalence rates for most drugs and for most antisocial behaviors. Methodological implications of these findings are discussed along with directions for further research.

Evaluating retailer behavior in preventing youth access to harmful legal products a feasibility test.

This article reports results from a feasibility study of a community effort to reduce the availability of legal products that youth can use to get high. The study evaluated the potential of youth purchase attempts to detect actual changes in retail availability of harmful legal products. These results were triangulated with self-reports from retailers about their own policies and practices. Before the intervention, less than half of retailers reported using any of six possible strategies identified as ways to reduce youth access to harmful products, and less than 8% of baseline youth attempts to purchase potentially harmful legal products were refused or questioned. After the low-dosage intervention, retailers reported increased use of three strategies and a statistically significant increase in the percentage of purchase attempts that were either questioned or refused by retail clerks. These findings (a) demonstrate the potential feasibility of retailer-focused environmental strategies and (b) support continued use of youth purchase attempts as a measure of actual retailer behavior.

An evaluation of retail outlets as part of a community prevention trial to reduce sales of harmful legal products to youth.

Communities across the nation have become increasingly concerned about inhalant use and use of harmful legal products among youth because of increasing prevalence rates and deleterious health consequences from abusing these products. The increasing concern of communities about inhaling and ingesting legal products has been coupled with increasing awareness and concern about ability of youth to access and abuse a variety of other legal retail products. There are few examples of scientifically designed community prevention projects that seek to reduce youth abuse of such legal products. This article describes a community prevention trial that is designed to reduce sales of inhalants and other harmful legal products to youth and demonstrates how the retailer component of the trial can be rigorously evaluated. It also shows how data from youth purchase attempts can complement survey data from retailers.