ucla integrated substance abuse programs (isap). csat mtp project goals: to study the clinical...
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UCLA Integrated Substance Abuse UCLA Integrated Substance Abuse Programs (ISAP)Programs (ISAP)
CSAT MTP Project Goals:CSAT MTP Project Goals: To study the clinical effectiveness of the To study the clinical effectiveness of the
Matrix ModelMatrix Model To compare the effectiveness of the To compare the effectiveness of the
Matrix model to other locally available Matrix model to other locally available outpatient treatmentsoutpatient treatments
To establish the cost and cost To establish the cost and cost effectiveness of the Matrix model effectiveness of the Matrix model compared to other outpatient treatmentscompared to other outpatient treatments
To explore the replicability of the Matrix To explore the replicability of the Matrix model and challenges involved in model and challenges involved in technology transfertechnology transfer
Matrix Model vs TAUMatrix Model vs TAURawson et al., 2004, AddictionRawson et al., 2004, Addiction
978 Methamphetamine users seeking 978 Methamphetamine users seeking treatment treatment
CSAT multi-site study; 1998-2002CSAT multi-site study; 1998-2002 Costa Mesa; San Diego; Hayward; Concord; Costa Mesa; San Diego; Hayward; Concord; San Mateo; Billings; HonoluluSan Mateo; Billings; Honolulu
Matrix Model vs Treatment as UsualMatrix Model vs Treatment as Usual Random assignmentRandom assignment
Inclusion CriteriaInclusion Criteria
Males or females, 18 years of age or older.Males or females, 18 years of age or older. Must meet DSM-IV criteria for Must meet DSM-IV criteria for
methamphetamine dependence methamphetamine dependence Willing to complete study forms and Willing to complete study forms and
provide urine samples. provide urine samples. Able to understand and complete rating Able to understand and complete rating
scales and follow instructions (with or scales and follow instructions (with or without assistance). without assistance).
Inclusion CriteriaInclusion Criteria
Able to understand and sign an Able to understand and sign an informed consent (with or without informed consent (with or without assistance). assistance).
Have the ability to understand the Have the ability to understand the English language, as well as the ability English language, as well as the ability to participate in treatment and to participate in treatment and understand treatment materials (with understand treatment materials (with or without assistance). or without assistance).
Exclusion CriteriaExclusion Criteria
Current medical or psychiatric condition Current medical or psychiatric condition causing a degree of impairment or instability causing a degree of impairment or instability such that it would interfere with program such that it would interfere with program participation and functioning and/or would participation and functioning and/or would preclude the primary treatment focus on the preclude the primary treatment focus on the problem of methamphetamine dependenceproblem of methamphetamine dependence
Candidates who meet DSM-IV criteria for Candidates who meet DSM-IV criteria for
dependence to opioids, alcohol, dependence to opioids, alcohol, benzodiazepines or other sedative/hypnotics benzodiazepines or other sedative/hypnotics and who will require detoxification and who will require detoxification
Exclusion CriteriaExclusion Criteria
Candidates who have not used Candidates who have not used methamphetamine within 30 days prior to the methamphetamine within 30 days prior to the study participation (participation begins one study participation (participation begins one week prior to randomization), unless they week prior to randomization), unless they were in a controlled environment (i.e. jail). were in a controlled environment (i.e. jail).
Candidates who have participated in any Candidates who have participated in any other chemical dependency treatment other chemical dependency treatment (inpatient rehab; therapeutic community; (inpatient rehab; therapeutic community; sober living facility; structured outpatient sober living facility; structured outpatient program) within 30 days of study participation program) within 30 days of study participation for an episode of seven days or longer. for an episode of seven days or longer.
Exclusion CriteriaExclusion Criteria
Candidates who are currently Candidates who are currently involved in a clinical research involved in a clinical research treatment project treatment project
Candidates with any medical, legal, Candidates with any medical, legal, housing, or transportation problem housing, or transportation problem which would preclude either safe or which would preclude either safe or consistent participation consistent participation
TAUTAU Steering committee decided between:Steering committee decided between:
Standard TAU for all sitesStandard TAU for all sites TAU for each site based on actual TAU for each site based on actual
practicepractice 8 TAUs resulted in:8 TAUs resulted in:
More relevance to sitesMore relevance to sites More variabilityMore variability 8 studies8 studies
TAUs represented best available TAUs represented best available option vs minimal contact comparisonoption vs minimal contact comparison
Overview of TAUsOverview of TAUsDuration
of Treatmen
t Intensive
Phase
Individual Sessions
Group Sessions
12-Step Program
Involvement
Site 1Site 1 8 weeks8 weeks 1x/wk 4-8 wks
30-50 minutes
4x/wk4-8 wks3 hrs
Families1x/wk
required; 1x/wk
4-8 wks
Site 2Site 2 12 weeks12 weeks 1x/wk12 wks
1 hr each
5x/wk x 2wk,
3x/wk x 2wks,
2x/wk x 8 wks
RecommenRecommendedded
Site 3Site 3 12 weeks12 weeks 1x/wk12 wks
1 hr each
NoneNone RecommenRecommendedded
Duration of
Treatment
Intensive Phase
Individual Sessions
Group Sessions
12-Step Program
Involvement
Site 4Site 4 16 weeks16 weeks 1x/wk 16 wks
10-15 min
3x/wk 16 wks
1 hr
required; 3x/wk16 wks
Site 5Site 5 12 weeks12 weeks 1x/wk 12 wks
30-60 min
3x/wk x 12wks2x/wk x 12wks90 min
60-90 min60-90 min
required; 1x/wk12 wks
Site 6Site 6 12 weeks12 weeks 1x/wk--2x/mo
12 wks 1 hr
2x/wk 12wks90 min
60-90 min60-90 min
RecommenRecommendedded
Overview of TAUsOverview of TAUs
Duration of
Treatment
Intensive Phase
Individual Sessions
Group Sessions
12-Step Program
Involvement
Site 7Site 7 16 weeks16 weeks 1x/wk 16 wks
1 hr each
2x/wk16 wks2 hrs
RecommenRecommendedded
Site 8Site 8 12 weeks12 weeks 2x/wk12 wks
1 hr each
1x/wk12 wks2 hrs
RequiredRequired
6 meetings6 meetings
Overview of TAUsOverview of TAUs
Baseline DemographicsBaseline Demographics
AgeAge MaleMale EducationEducation Meth useMeth use Marijuana useMarijuana use Alcohol useAlcohol use
32.8 years32.8 years
55%55%
12.2 years12.2 years
7.5 years7.5 years
7.2 years7.2 years
7.6 years7.6 years
Ethnic Identification of Participants
60
2 3
17 18
0
10
20
30
40
50
60
Ethnic Identification
Perc
ent
caucasianafrican amernative amerasian/ pac islhispanic
Route of Methamphetamine UseRoute of Methamphetamine Use
24%
11%
64%
0%
10%
20%
30%
40%
50%
60%
70%
Route of Administration
Per
cent
Usi
ng b
y R
oute
nasalsmokeiv
Weeks in TreatmentWeeks in Treatment
5
8.2
0
1
2
3
4
5
6
7
8
9
Matrix TAU
Wee
ks
**
Weeks Continuous AbstinenceWeeks Continuous Abstinence
3
6
0
1
2
3
4
5
6
7
Matrix TAU
Wee
ks
**
Mean Number of UA’s that Mean Number of UA’s that werewere
MA-free during treatmentMA-free during treatment
0
2
4
6
8
10 MatrixTAU
Mean Number of Weeks in Treatment
02468
1012
SITE
mea
n nu
mbe
r of
vis
its MatrixTAU
11.3
4.3 4.4
0
2
4
6
8
10
12
Matrix
Day
s
Baseline
Discharge
6-month FU
Self-report of MA use during the past 30 daysat baseline, discharge, and 6-month follow-up.
Urine Results: % Meth-Urine Results: % Meth-freefree
66% 65%69% 67%
59%55%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Matrix TAU
% m
eth-
free
Discharge6 months12 months
Urine Results: % Meth-Urine Results: % Meth-freefree
66%69%
59%
25%30%35%40%45%50%
55%60%65%70%75%
Matrix
% m
eth-
free
Discharge6 months12 months
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