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J Subst Abuse Treat. 2019 Feb;97:68-74. doi: 10.1016/j.jsat.2018.11.011. Epub 2018 Nov 24.

A randomized clinical trial of the Recovery Line among methadone treatment patients with ongoing illicit drug use.

Author information

1
Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; VA Connecticut Healthcare System, West Haven, 06516, CT, USA; APT Foundation, New Haven, 06511, CT, USA. Electronic address: brent.moore@yale.edu.
2
Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; VA Connecticut Healthcare System, West Haven, 06516, CT, USA; APT Foundation, New Haven, 06511, CT, USA.
3
Department of Psychiatry, Yale School of Medicine, New Haven, 06511, CT, USA; APT Foundation, New Haven, 06511, CT, USA.
4
Department of Internal Medicine, Yale University School of Medicine, New Haven, 06510, CT, USA.

Abstract

BACKGROUND:

Relapse, drug use, and treatment dropout are common challenges facing patients receiving methadone. Though effective, multiple barriers to face-to-face counseling exist. The Recovery Line (RL), an automated, self-management system based on Cognitive Behavioral Therapy, is a phone-based adjunctive treatment that provides low cost, consistent delivery and immediate therapeutic availability 24 h a day.

METHODS:

The current study was a 12-week randomized clinical efficacy trial of treatment-as-usual (TAU) only or RL + TAU for methadone treatment patients with continued illicit drug use (N = 82). Previous small trial phases evaluated methods to increase participant engagement and use of the RL and were incorporated into the current RL version. Primary outcomes were days of self-reported illicit drug abstinence and urine screens negative for illicit drugs.

RESULTS:

Days of self-reported illicit drug abstinence improved for patients in RL + TAU but not in TAU. Percent of urine screens negative for illicit drugs, coping skills efficacy, and retention in methadone treatment did not differ by condition. Patients in RL + TAU attended more substance use disorder treatment and self-help group sessions during treatment than those in TAU. RL system use was generally low and more system use was correlated with abstinence outcomes.

CONCLUSIONS:

Although the RL did not impact urine screen outcomes, it increases self-reported abstinence. Additional methods to increase patient engagement with automated, self-management systems for substance use disorder are needed.

KEYWORDS:

Computer-based treatment; IVR; Methadone treatment; Opioid-related disorders

PMID:
30577901
PMCID:
PMC6310054
[Available on 2020-02-01]
DOI:
10.1016/j.jsat.2018.11.011

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