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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 Grant from St. Francis House
"St. Francis House Linking, Evaluation, Assessment, & Data (LEAD) System," PI: Sarah Nelson, Ph.D.
The Division on Addiction continues its collaboration with St. Francis House, the largest day shelter in New England for homeless individuals, on the Linking, Evaluation, Assessment & Data System (LEAD). LEAD is a technological solution for conducting comprehensive assessments with St. Francis House guests, tracking their use of services and programs, and evaluating the impact of those programs and services. The Division has been working with SFH to develop and implement this comprehensive relational database system capable of tracking guests’ paths through SFH programs and services, integrating assessment information from multiple programs/services and times, and generating output at the individual and aggregate level. The purpose of such a system is to assess how well SFH is providing integrated services, how specific services can be improved, and whether certain services can be targeted to certain guests. In addition, the LEAD system will improve the intake and data collection processes at SFH, making it easier for SFH employees to collect, maintain, integrate, and share information about their guests.
New Grant from SAMHSA with the Duffy Health Center
SAMHSA Cooperative Agreements to Benefit Homeless Individuals
Harvard/Duffy Health Center Partnership through SAMHSA - Heather Gray, Ph.D.
will be the project evaluator for a cooperative agreement recently awarded
by Substance Abuse and Mental Health Services Administration (SAMHSA) to the
Duffy Health Center, Cape Cod’s leading provider of services to homeless and
at risk individuals. The three-year project will increase access to
permanent housing for chronically homeless persons, using strategies and
interventions based on Duffy’s successful integrated model of care that
includes outreach, benefits enrollment, case management, behavioral health
and primary care services and permanent supportive housing. Dr. Gray is
partnering with Duffy to evaluate outcomes related to best practices of
trauma-informed care, comprehensive case management, Motivational
Interviewing, and Housing First. Expected outcomes are to improve the
health, stability, and life functioning of the target populations; reduce
frequency and duration of emotional instability or relapse from substance
abuse; and increase housing stability. The Duffy Health Center was one of 20
agencies competing from across the country for the grant.
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.
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.
Accepting Applications for our Undergraduate Summer Research Mentorship
Please visit our opportunities page for more details.
Recruitment Opportunities for Studies
Click here for more information about a smoking cessation study, as well as studies for veterans.
Benzodiazepine use during buprenorphine treatment for opioid dependence: Clinical and safety outcomes
Background: Prescribing benzodiazepines during buprenorphine treatment is a topic of active discussion. Clinical benefit is unclear. Overdose, accidental injury, and benzodiazepine misuse remain concerns. We examine the relationship between benzodiazepine misuse history, benzodiazepine prescription, and both clinical and safety outcomes during buprenorphine treatment. Methods: We retrospectively examined outpatient buprenorphine treatment records, classifying patients by past-year benzodiazepine misuse history and approved benzodiazepine prescription at intake. Primary clinical outcomes included 12-month treatment retention and urine toxicology for illicit opioids. Primary safety outcomes included total emergency department (ED) visits and odds of an ED visit related to overdose or accidental injury during treatment. Results: The 12-month treatment retention rate for the sample (N = 328) was 40%. Neither benzodiazepine misuse history nor benzodiazepine prescription was associated with treatment retention or illicit opioid use. Poisson regressions of ED visits during buprenorphine treatment revealed more ED visits among those with a benzodiazepine prescription versus those without (p < 0.001); benzodiazepine misuse history had no effect. The odds of an accidental injury-related ED visit during treatment were greater among those with a benzodiazepine prescription (OR: 3.7, p < 0.01), with an enhanced effect among females (OR: 4.7,p < 0.01). Overdose was not associated with benzodiazepine misuse history or prescription. Conclusions: We found no effect of benzodiazepine prescriptions on opioid treatment outcomes; how-ever, benzodiazepine prescription was associated with more frequent ED visits and accidental injuries, especially among females. When prescribing benzodiazepines during buprenorphine treatment, patients need more education about accidental injury risk. Alternative treatments for anxiety should be considered when possible, especially among females. Click here to visit the Library & Archives page.
Moving ahead: Evaluation of a work-skills training program for homeless adults
This study examines the impact of a work-skills program grounded in an integrated services approach on both employment and related life domains among homeless individuals. Six hundred thirty-eight participants in a 14-week work-skills program at a large day center in New England completed assessments at intake between 1999 and 2007; a subsample of 333 also completed assessments at graduation from the program; a smaller subsample of 55 participants were re-assessed 6 months after graduation. These assessments measured work and related life skills, employment, housing status, general health status, substance use, self-esteem and self-efficacy, and legal involvement. Results revealed improvement in all types of work and related life skills, employment and income, and multiple other life domains from baseline to graduation and follow-up. Exploratory analyses suggested that improvements in work and related life skills were associated with improvement in self-esteem and self-efficacy, and that these improvements predicted stable housing situations at follow-up. Overall, these findings indicate that, for individuals struggling with the challenges of homelessness, completion of a work-skills program has a positive impact on skills and employment, and on a diverse set of life domains. Click here to visit the Library & Archives page.
Gray, H. M., LaPlante, D. A., & Shaffer, H. J. (2012). Behavioral characteristics of Internet gamblers who trigger corporate responsible gambling interventions. Psychology of Addictive Behaviors, Online First. doi: 10.1037/a0028545 (Password Protected)
LaBrie, R. A., Peller, A. J., LaPlante, D. A., Bernhard, B., Harper, A., Schrier, T., & Shaffer, H. J. (2012). A brief self-help toolkit intervention for gambling problems: A randomized multi-site trial. American Journal of Orthopsychiatry, 82(2), 278-289. doi: 10.1111/j.1939-0025.2012.01157.x (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)
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