Web-based behavioral treatment for substance use disorders as a partial replacement of standard methadone maintenance treatment

• Published in: Journal of substance abuse treatment Vol. 46; no. 1; pp. 43 - 51
• Main Authors: Marsch, Lisa A., Ph.D, Guarino, Honoria, Ph.D, Acosta, Michelle, Ph.D, Aponte-Melendez, Yesenia, M.A, Cleland, Charles, Ph.D, Grabinski, Michael, B.A., MCSD, Brady, Ronald, M.D, Edwards, Joyce, B.A., CASAC
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2014; Elsevier Limited
• Subjects: Abstinence; Addictive behaviors; Adult; Behavior Therapy - methods; Behavioral therapy; Clinical trials; Community Health Services - methods; Computer; Computer based; Counseling; Effectiveness studies; Female; Follow-Up Studies; Humans; Internet; Male; Methadone - administration & dosage; Middle Aged; Opiate Substitution Treatment - methods; Opioid; Opioid-Related Disorders - rehabilitation; Opioids; Psychiatry; Substance abuse; Substance Abuse Detection - methods; Substance abuse treatment; Treatment; Treatment methods; Web; Computer; Opioid; Behavioral therapy; Treatment; Internet; Web
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2013.08.012

Abstract 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 12 months 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.