The Division on Addiction - Cambridge Health Alliance

The Cambridge Police Department (CPD) has set up a Safety Net Collaborative to promote mental health and limit youth involvement in the juvenile justice system through coordinated services for Cambridge youth and their families. Safety Net's diversion program targets first-time juvenile offenders and focuses on connecting them to the necessary services and programs to prevent recidivism. The Cambridge Department of Human Service Program assists the CPD in connecting kids in the program to five youth centers located throughout the city. Cambridge Health Alliance (CHA) provides phone and in-person consultation, training, evaluation and treatment services as well as outreach with officers to schools and families. Diverted youth can seek treatment at CHA, or in other behavioral health settings. At its five-year juncture, the initiative needs clear measures of positive outcomes and a more specific plan for data collection and analysis. The Division on Addiction will work with the CPD's Community Relations Division to identify measurable predictor and outcome variables to look at whether involvement in the Safety Net program is linked to positive outcomes.

Division Staff Present New Research at the Harvard Psychiatry Research Day Poster Session and Mysell Lecture and the Cambridge Health Alliance Academic Poster Session

Research staff from the Division on Addiction present posters at the Harvard Psychiatry Research Day Poster Session and Mysell Lecture and the Cambridge Health Alliance Academic Poster Session.

Harvard Psychiatry Research Day Poster Session and Mysell Lecture - March 19, 2014

The Cambridge Health Alliance Academic Poster Session - April 9, 2014

Please click on the below links to view the posters.

New Grant from ABMRF: The Foundation for Alcohol Research

"The effect of tailoring a testimonial message on excessive drinking by personal relevance on implicit and explicit narrative persuasion," PI: Julia Braverman, Ph.D.

Research suggests that narrative persuasion (i.e., telling vivid stories to promote attitude change) might be an effective public health promotion technique. However, it is unclear whether making a narrative story more personally relevant increases its persuasiveness. This research program explores this possibility for excessive alcohol consumption. It is well known that alcohol abuse impairs various domains of life, e.g., health, social relationships, and career. The importance of these domains varies from person to person. Hence, some people are typically more concerned about their social relationships, whereas others pay more attention to their career, or health. We examine the effect of matching the message content to what individuals find most personally relevant with two experiments. For the first experiment, we will ask participants randomly assigned to read personally relevant, or not, stories about alcohol. We will determine whether matching personal relevance along three domains (relationships, career, or health) positively affects individuals’ psychological immersion into the story, alcohol related attitudes, and self-reported drinking. For the second experiment, we will use a priming technique to make a specific domain temporarily more salient (i.e., “activated”) to an individual. This will allow us to investigate if induced relevance to self can yield similarly positive alcohol-related health outcomes.

New Grants from NCRG

"A benchmark study for monitoring exposure to new gambling," PI: Sarah Nelson, Ph.D.

The Commonwealth of Massachusetts is nearing an historic change to its legal gambling landscape. The expansion of legal gambling opportunities to include large resort style casinos presents a unique opportunity to learn about the short- and long-term ramifications of such expansion on public health. Because this period represents a natural experiment within Massachusetts, there is a limited window of opportunity to collect accurate baseline data. To determine how new gambling opportunities impact the public's gambling-related health, it is imperative to establish baseline estimates of gambling-related behaviors and health prior to the opening of new gambling venues and then track the changes in these individuals' health and behavior across time. This pilot project will survey the Massachusetts arm of an existing nationally representative online panel about their current gambling behaviors, problems, and attitudes, as well as other leisure behaviors, spending habits, substance use, and mental health to establish a benchmark for a future long-term longitudinal investigation of the effect of gambling expansion on public health.

The final report for this study is now available on our Library and Archives page.

"Expanding the study of actual Internet gambling behavior: Exposure and adaptation with a newly opened market," PI: Heather Gray, Ph.D.

In this work, the Division on Addiction will partner with researchers from Reykjavik University and the University of Iceland to conduct an analysis of actual Internet gambling records from a regional Internet gaming provider. We will use these records to conduct an epidemiological description of gamblers and gambling behavior; to describe the gambling behavior of most active gamblers; to describe the gambling behavior of gamblers identified as "high risk;" and to describe gamblers' adaptation to new gambling opportunities. Results from these studies will provide a more complete description of how people gamble online.

New Multi-Year Grant with The Century Council to Reduce Repeat DUI by Developing a Computerized Assessment and Referral System (CARS)

New research has identified that repeat DUI offenders often suffer from a number of psychiatric disorders (e.g., Shaffer et al., 2007), suggesting that untreated mental health issues contribute to the persisting rate of DUI. To combat this pressing public health problem and to build a foundation for expanded treatment, the Division of Addiction, with support from The Century Council, has begun work to develop and test a computerized clinical report generator tool, the Computerized Assessment and Referral System (CARS), for use in DUI intervention and treatment settings. CARS will package a powerful mental health assessment tool, the Composite International Diagnostic Interview (CIDI: Kessler & Ustun, 2004) with a user-friendly interface, increased flexibility, and immediate personalized output, to create a tool that can be used easily by DUI facility staff to screen DUI offenders and target interventions to address comorbid mental health issues. Dr. Ronald Kessler, Professor of Health Care Policy at Harvard Medical School, co-director of the World Health Organization’s World Mental Health Surveys, and an original developer of the CIDI, and his team are collaborating with the Division on the development of CARS.

Shaffer, H. J., Nelson, S. E., LaPlante, D. A., LaBrie, R. A., Albanese, M., & Caro, G. (2007). The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment sentencing option. Journal of Consulting and Clinical Psychology, 75(5), 795-804.

Kessler, R. C., & Ustun, T. B. (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13(2), 93-121.

For the original press release, click here.

April is Alcohol Awareness Month

The BASIS is featuring a Special Series on Alcohol Awareness Month during April

The Division on Addiction is dedicating four BASIS issues to responsible drinking during Alcohol Awareness Month. Please visit The BASIS for more details.

The Century Council is going FAAR!

The Century Council, dedicated to fighting drink driving and underage drinking, announces a new name today: the Foundation for Advancing Alcohol Responsibility (FAAR) along with the goal to spark two million conversations about alcohol responsibility during Alcohol Awareness Month.

Cambridge Health Alliance Readiness for Gambling Expansion (CHARGE)

Cambridge Health Alliance is getting ready for gambling expansion in Massachusetts. The CHARGE Initiative is an education, information, and awareness effort that will help people dealing with gambling disorder. Read more about CHARGE here.

New Online CME Course

Disordered Gambling in Your Practice: Information and Resources for Dealing with Disordered Gambling

Course Directors: Heather M. Gray, Ph.D., Debi A. LaPlante, Ph.D., and Howard Shaffer, Ph.D., C.A.S.

The Division is proud to announce the launch of our latest online CME course, Disordered Gambling in Your Practice: Information and Resources for Dealing with Disordered Gambling. The course is dedicated to increasing providers’ understanding of disordered gambling and its importance to their practice. To learn more about the course, or to register, please click here.

Recruitment Opportunities for Studies

Click here for more information about a smoking cessation study, as well as studies for veterans.

Gambling involvement: Considering frequency of play and the moderating effects of gender and age

Research indicates that specific types of gambling, such as electronic gaming machines, are associated with increased odds of experiencing gambling problems. Recent findings suggest that to advance our understanding of gambling-related problems scientists need to focus less on a simple association (e.g., specific gambling type) and more on complex models that include the extent of gambling involvement. The objective of this study is to advance this area of investigation by establishing the generalizability of the involvement effect to the general population of Canada, as well as to examine two potential moderating factors: gender and age. Secondary data analysis of the nationally representative Canadian Community Health Survey (CCHS) cycle 1.2 (data collected during 2002, response rate = 77 %, n=18,913) using logistic regression models were conducted. All types of gambling were associated with problem gambling. However, when adjusting for gambling involvement (i.e., the number of games played during the past year), these specific game relationships were either eliminated or attenuated. Significant relationships remained for instant win lottery tickets, bingo, card and/or board games, electronic gaming machines outside of casinos, electronic gaming machines inside casinos, other casino gambling, horse racing, sports lotteries, and games of skill. For many types of gambling, the nature of the relationships seemed to be a function of the frequency of engagement with specific games. Gender and age did not moderate these findings. These findings indicate that focusing on a narrow direct cause (e.g., game type) for gambling problems needs to shift towards a more complex model that also includes the level of gambling involvement. Click here to visit the Library & Archives page.

Associations between National Gambling Policies and Disordered Gambling Prevalence Rates within Europe

Policymakers and other interested stakeholders currently are seeking information about the comparative effectiveness of different regulatory approaches to minimizing gambling-related harm. This study responds to this research gap by exploring associations between gambling policies and disordered gambling prevalence rates. We gathered information about gambling policies for thirty European jurisdictions and past-year prevalence rates for disordered gambling for twelve of these jurisdictions. We present policy trends and prevalence rates and then describe the level of association between policy and prevalence. We observe one statistically significant association between policy and prevalence: rates of sub-clinical (i.e., Level 2) disordered gambling were higher within environments that mandated less strict regulation of advertising for online gambling. Finally, we discuss the implications of our research in the context of the current process regarding the pan-European regulation of gambling. Our findings do not offer evidence for certain assumptions made in the past by the European judiciary. Click here to visit the Library & Archives page.

Expanding the Study of Internet Gambling Behavior: Trends within the Icelandic Lottery and Sportsbetting Platform

As rates of Internet gambling participation increase worldwide, so too does the need to understand how people engage in this form of gambling. This study represents the first examination of actual Internet gambling records within Iceland, a Nordic country with an active Internet lottery market that imposes strict regulations on gambling operator licenses. We summarized electronic betting records of a cohort of subscribers to the Internet betting service provider I´slensk Getspa´. We observed that the typical subscriber bet approximately 3 days per month and made fewer than two bets per gambling day, each worth approximately the equivalent of $4 US. Subscribers lost the bulk (96 %) of the amount they wagered, for a total loss of approximately $40 across the 2-year window of observation. Although these observations do not support the view of Internet gambling as an activity that is inherently risky for the typical subscriber, we did observe discontinuity across the distributions of gambling behavior, with the top 1 % of subscribers making more than three bets per day. Click here to visit the Library & Archives page.

Gambling Impact Study

Part 1, Section A: Assessment of the Florida Gaming Industry and its Economic Effects

Part 1, Section B: Assessment of Potential Changes to Florida Gaming Industry and Resulting Economic Effects

Part 2: Statistical Relationships between Gaming and Economic Variables for Communities

During fall 2013, Spectrum Gaming Group released a comprehensive report about the impact of expanded gambling for the State of Florida. The Division contributed to this report, specifically providing an assessment of likely social costs associated with expanded gambling. The final report is available here: http://www.leg.state.fl.us/GamingStudy/.

Recently Published:

Braverman, J., LaPlante, D. A, Nelson, S. E, & Shaffer, H. J. (2013). Using cross-game behavioral markers for early identification of high-risk Internet gamblers. Psychology of Addictive Behaviors, 27(3), 868-877. doi: 10.1037/a0032818 (Password Protected)

LaPlante, D. A. (2013). Responsible drinking for women: A Harvard Medical School guide. Retrieved from http://www.amazon.com/Responsible-Drinking-Harvard-Medical-ebook/dp/B00EV8XU36/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1378397095&sr=1-1&keywords=responsible+drinking+for+women. (eBook Available for Purchase Online)

LaPlante, D. A., Nelson, S. E., & Gray, H. M. (2013). Breadth and depth involvement: Understanding Internet gambling involvement and its relationship to gambling problems. Psychology of Addictive Behaviors, Online First. doi: 10.1037/a0033810 (Password Protected)

Schuman-Olivier, Z., Hoeppner, B. B., Weiss, R. D., Borodovsky, J., Shaffer, H. J., & Albanese, M. J. (In Press). Benzodiazepine use during buprenorphine treatment for opioid dependence: Clinical and safety outcomes. Drug and Alcohol Dependence. doi: 10.1016/j.drugalcdep.2013.04.006 (Password Protected)

Shaffer, Howard J, & LaPlante, Debi A. (2013). Considering a critique of pathological gambling prevalence research. Addiction Research and Theory, 21(1), 12-14. doi: 10.3109/16066359.2012.715223 (Password Protected)