Kathlene Tracy1, Leah Wachtel1, Emily Goldmann2, Joseph Nissenfeld3, Mark Burton3, Marc Galanter3, Samuel A Ball4. 1. Psychosocial Division, Addiction Institute Mount Sinai (AIMS), Laboratory of Psychosocial Processes in Addiction, Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, New York. 2. College of Global Public Health, New York University, New York, New York. 3. Division of Alcoholism and Drug Abuse, New York University School of Medicine, Department of Psychiatry, New York, New York. 4. Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut.
Abstract
OBJECTIVE:Mentorship for Addiction Problems (MAP) is a new behavioral treatment formalizing client-to-client mentorship relationships as an adjunct to standard outpatient substance use disorder treatment. We tested the preliminary efficacy of MAP in reducing substance use and associated barriers to successful treatment outcomes. METHOD: A total of 65 participants (17 later recovery participants [LRPs] and 48 early recovery participants [ERPs]) with substance use disorders were randomized to MAP + Treatment as Usual (TAU) or TAU alone. Within MAP, for each cohort, a pool of 4-5 mentors (LRPs) was formed and engaged in mentoring activities for 24 weeks until 12-13 mentees (ERPs), newly admitted, had participated in MAP for 12 weeks. Behavioral and biological measures were conducted at baseline, weekly, monthly, and termination for all participants and during the 12-week follow-up for ERPs. RESULTS: Substance use declined across both conditions for ERPs (N = 48) during treatment, Weeks 0-12 (p = .001); however, on average, ERPs in the MAP intervention used significantly fewer days than controls during Treatment Weeks 1-12 (p = .013) and during Follow-Up Weeks 13-24 (p = .043). Addiction Severity Index alcohol and drug use scores increased in TAU and decreased in MAP during Follow-Up Weeks 13-24 for ERPs, alcohol: b = -0.08, SE = 0.03, t(47) = -2.97, p = .005; drug use: b = -0.02, SE = 0.01, t(47) = -2.36, p = .023. In addition, there was high patient interest in MAP and good fidelity to delivery of treatment. CONCLUSIONS:MAP shows promise assisting in the reduction of substance use early in treatment when vulnerability and risk for relapse is high and has a positive impact on serious problems undercutting addiction treatment efficacy.
RCT Entities:
OBJECTIVE: Mentorship for Addiction Problems (MAP) is a new behavioral treatment formalizing client-to-client mentorship relationships as an adjunct to standard outpatient substance use disorder treatment. We tested the preliminary efficacy of MAP in reducing substance use and associated barriers to successful treatment outcomes. METHOD: A total of 65 participants (17 later recovery participants [LRPs] and 48 early recovery participants [ERPs]) with substance use disorders were randomized to MAP + Treatment as Usual (TAU) or TAU alone. Within MAP, for each cohort, a pool of 4-5 mentors (LRPs) was formed and engaged in mentoring activities for 24 weeks until 12-13 mentees (ERPs), newly admitted, had participated in MAP for 12 weeks. Behavioral and biological measures were conducted at baseline, weekly, monthly, and termination for all participants and during the 12-week follow-up for ERPs. RESULTS: Substance use declined across both conditions for ERPs (N = 48) during treatment, Weeks 0-12 (p = .001); however, on average, ERPs in the MAP intervention used significantly fewer days than controls during Treatment Weeks 1-12 (p = .013) and during Follow-Up Weeks 13-24 (p = .043). Addiction Severity Index alcohol and drug use scores increased in TAU and decreased in MAP during Follow-Up Weeks 13-24 for ERPs, alcohol: b = -0.08, SE = 0.03, t(47) = -2.97, p = .005; drug use: b = -0.02, SE = 0.01, t(47) = -2.36, p = .023. In addition, there was high patient interest in MAP and good fidelity to delivery of treatment. CONCLUSIONS: MAP shows promise assisting in the reduction of substance use early in treatment when vulnerability and risk for relapse is high and has a positive impact on serious problems undercutting addiction treatment efficacy.