title: A randomized pilot clinical trial to evaluate the efficacy of Community Reinforcement and Family Training for Treatment Retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification.
abstract: BACKGROUND
  Detoxification with psychosocial counseling remains a standard opioid-use disorder treatment practice but is associated with poor outcomes. This study tested the efficacy of a newly developed psychosocial intervention, Community Reinforcement Approach and Family Training for Treatment Retention (CRAFT-T), relative to psychosocial treatment as usual (TAU), for improving treatment outcomes.
  
  
  METHODS
  A randomized, 14-week trial with follow-up visits at 6 and 9 months post-randomization conducted at two substance use disorder (SUD) treatment programs. Opioid-dependent adults (i.e., identified patient - IP) enrolled in a residential buprenorphine-detoxification program and their identified concerned significant other (CSO) was randomized to CRAFT-T (n=28 dyads) or TAU (n=24 dyads). CRAFT-T consisted of two sessions with the IP and CSO together and 10 with the CSO alone, over 14 weeks. TAU for the CSOs was primarily educational and referral to self-help. All IPs received treatment as usually provided by the SUD program in which they were enrolled. The primary outcome was time to first IP drop from treatment lasting 30 days or more. Opioid and other drug use were key secondary outcomes.
  
  
  RESULTS
  CRAFT-T resulted in a moderate but non-significant effect on treatment retention (p=0.058, hazard ratio=0.57). When the CSO was parental family, CRAFT-T had a large and significant effect on treatment retention (p<0.01, hazard ratio=.040). CRAFT-T had a significant positive effect on IP opioid and other drug use (p<0.0001).
  
  
  CONCLUSIONS
  CRAFT-T is a promising treatment for opioid use disorder but replication is needed to confirm these results.
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA; Maryhaven, Columbus, OH 43207, USA. Electronic address: Gbrigham@maryhaven.com.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Brigham
authors.affiliation: Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Slesnick
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA.
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Winhusen
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Lewis
authors.affiliation: Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Xiamei
authors.initials: X
authors.lastname: Guo
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA; Cincinnati VA Medical Center, Cincinnati, OH 45220, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Somoza
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology*; D010865:Pilot Projects; D011613:Psychotherapy / Q000379:methods*; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine
keywords: Addiction; Dependence; Family; Treatment