Web-based behavioral treatment for substance use disorders as a partial replacement of standard methadone maintenance treatment.
This study is the first experimental trial to evaluate the effectiveness of a Web-based behavioral intervention when deployed in a model where it partially substituted for standard counseling in a community-based specialty addiction treatment program. New opioid-dependent intakes in methadone maintenance treatment (n=160) were randomly assigned for 12months to either: (1) standard treatment or (2) reduced standard treatment plus a Web-based psychosocial intervention, the Therapeutic Education System (TES). Results demonstrated that replacing a portion of standard treatment with TES resulted in significantly greater rates of objectively measured opioid abstinence (48% vs. 37% abstinence across all study weeks; F(1, 158)=5.90, p<.05 and 59% vs. 43% abstinence on weeks participants provided urine samples for testing; F(1, 158)=8.81, p<.01). This result was robust and was evident despite how opioid abstinence was operationally defined and evaluated. The potential implications for service delivery models within substance abuse treatment programs and other healthcare entities are discussed.
Dartmouth College, Hanover, NH. Electronic address: Lisa.A.Marsch@Dartmouth.edu.
Lisa A
LA
Marsch
Honoria
H
Guarino
Michelle
M
Acosta
Yesenia
Y
Aponte-Melendez
Charles
C
Cleland
Michael
M
Grabinski
Ronald
R
Brady
Joyce
J
Edwards
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003153:Community Health Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D015813:Substance Abuse Detection / Q000379:methods
D008691:Methadone
Behavioral therapy; Computer; Internet; Opioid; Treatment; Web