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Table 6 Summary of evidence-based mixed sud group treatment for adults

From: A review of research-supported group treatments for drug use disorders

Study Patient Characteristicsa Treatment Description Manual Study Characteristicsb,c Results
Downey et al., 2000 [82] 14 buprenophrine maintained poly-drug users (cocaine plus heroin). (SCID). Mean age 40 years, 39% female, 35% Caucasian. 18 weeks:
1. Individual CBT (6 sessions) plus 12 session (weekly) group therapy (CBT; relapse prevention)
2. CBT based plus vouchers (VBRT)
1. Yes
2. Yes
RAAT; post-test at end of 18-week tx; 37% tx completion/ f/u rate in CBT; 65% tx completion/f/u VBRT. No significant differences on treatment outcome. Among the subsample that produced one or more poly-drug free urine results, VBRT participants had significantly increased cocaine abstinence.
Greenfield et al., 2007 [52] 13 (for pilot) and 31 (in trial) recruited patients with SUD (other than nicotine; SCID), substance use within 60 days of baseline, and no need for medical detoxification, mandate to treatment, psychosis, PTSD, concurrent self-help group treatment. Mean age 58 years for GDC and 45 for WRG, 100% female, predominantly Caucasian. 12 weeks, 90-min sessions, 1x per week:
1. Group Drug Counseling (GDC; mixed gender; 12 weeks)
2. Women’s Recovery Group (WRG; author)
1. Yes
2. Yes
RAWC; 6-month f/u. 87% f/u rate, 78% tx completion. Pilot testing of WRG evidenced significantly greater reductions in average drinks/drinking day than GDC at 6-month f/u. WRG was equally effective as mixed-gender GDC in reducing substance use during the 12-week in-treatment phase, but demonstrated significantly greater improvement in reductions in drug and alcohol use over the f/u compared with GDC. Women were significantly more satisfied with WRG than GDC
Margolin et al., 2003 [83] 90 HIV-seropositive, methadone-maintained injection drug users with opioid dependence, and abuse or dependence on cocaine (screened at intake, utilizing Addiction Severity Index). Mean age 41 years, 30% female, 48.9% African American, 15.6% Hispanic. 6-months of methadone maintenance plus:
1. HIV Harm Reduction Program (HHRP; twice weekly, 2-h groups)
2. Active control that included harm reduction components recommended by the National AIDS Demonstration Research Project (six sessions).
1. Yes
2. Yes
RAWC; 6- and 9-month f/u. 71% 6-month f/u rate, 70% 9-month f/u rate. 64.4% tx completion. Both groups showed reductions in risk behaviors. HHRP evidenced less use of illicit opiates and more adherence to antiretroviral medications; at follow-up, they had lower addiction severity scores and were less likely to have engaged in high risk behavior compared to control.
Marques & Formigioni (2001) [84] 155 recruited alcohol and/or drug dependent patients (standardized assessment interview). Mean age of drug dependent patients 25 years Mean age of AD patients 41 years, 8% female. No ethnicity data reported. 17 sessions over 8 months (1 session per week during Month 1–2, 1 session every 2 weeks in Month 3–5, 1 session per month during Month 6–8.
1. Individual CBT (IT; structured)
2. Group CBT (GT; structured)
1. Yes
2. Yes
RAAT; 15-month f/u. 66% f/u rate in IT, 70% f/u rate in GT. IT attended average of 7 sessions, GT attended average of 8 sessions. At follow- up the two formats presented similar outcomes, higher compliance in GT (66.7%)
McKay et al., 2005 [85] 359 referred patients with AD or CD (SCID). Mean age 42 years, 17% female, 77% African American. 12-week continuing care interventions:
1. weekly telephone monitoring and counseling combined with a support group in the first 4 weeks (TEL);
2. twice-weekly individualized relapse
prevention (RP)
3. twice-weekly standard group counseling (STND; 12 step).
1. Yes
2. Yes
3. Yes
RAAT; 3, 6, 9- and 12-months f/u. 90% f/u rates. The average number of sessions was 14.12 in STND, 14.41 in RP and 10.94 in TEL. Days of abstinence were higher in STND than TEL. Higher scores on a composite risk indicator indicated higher abstinence rates in STND than TEL and lower composite risk scores indicated higher abstinence rates in TEL than STND.
Nemes et al., 1999 [86] 412 patients in a therapeutic community with multiple drug/alcohol use dependencies/abuse (SCID. Mean age “mid-thirties”, 23% SC females, 33% AP females, primarily African American. 12-month program (inpatient and outpatient):
1. Standard Care (SC, 10 months inpatient, 2 months outpatient)
2. Abbreviated program (AP, 6 months inpatient, 6 months outpatient)
1. No
2. No
RAWC; 6-month f/u. 93% f/u rate. SC completed average of 8.2 months of program; AP completed average of 8.6 months of program. Both groups had reductions in arrests and drug use. No significant differences between groups.
Rawson et al., 2006 [87] 171 recruited individuals with CD or methamphetamine abuse (SCID), and no AD or benzodiazepine dependence, or court mandated to treatment. Mean age 36 years, 24% female, 32% African American. 16-weeks:
1. Contingency Management (CM; vouchers for stimulant-free urine samples; three urine samples per week and meet briefly with the CM technician)
2. CBT group (CBT; three 90-min group sessions each week, for 16 weeks).
3. CM plus CBT groups (CM-CBT; separate sessions)
1. Yes
2. Yes
3. Yes
RAAT; Baseline and weeks 17, 26 and 52 f/u. 81% f/u rate. 60% CM completed tx, 59% CM-CBT completed tx, and 40% CBT completed tx. CM produced better retention and lower rates of stimulant use during the study. Stimulant use was reduced from baseline levels at all f/u points for all groups and urinalysis data did not differ between groups at f/u. CM produced evidence of efficacy during treatment application, but CBT produced comparable longer-term outcomes. There was no evidence of an additive effect in CM-CBT.
Schottenfeld et al., 2000 [88] 117 patients with opioid dependence and CD or cocaine abuse (SCID) without psychosis and not suicidal or pregnant. Mean age 34 years, 49% female, 64% Caucasian. In addition to maintenance medications- 24 weeks of:
1. Group Drug Counseling (GDC; weekly, 1-h
group DC sessions).
2. Community Reinforcement Approach (CRA; met in individual sessions with a CRA therapist twice weekly during the first 12 weeks and then weekly during the following 12 weeks).
1. Yes
2. Yes
RAAT; 9-week ff/u. No f/u rate reported. Tx completion for GDC was 59.6 and 61.7% for the CRA. There were no significant differences in retention or drug use. The total number of hours and average hours per week engaged in nondrug-related activities was higher for CRA patients who achieved abstinence from opioids, cocaine, or both combined.
Smith et al., 1999 [89] 383 inpatient veterans, meeting AD, CD or amphetamine dependence (Semi-structured interview). Mean age 40–50 years, 0% female, 11–46% of participants in each group were African American. Between 21 and 28 days of treatment:
1. Standard treatment program (STP; daily group counseling, family outreach, 12-step program introduction, four 2-h. sessions for family)
2. Enhanced treatment program (ETP; 10 h. per week, twice weekly groups on relapse prevention and interpersonal counseling)
1. No
2. Yes
1st cohort completed STP; 2nd cohort completed ETP; 3- and 12-month f/u. 92% f/u rate at 3-month and 83% f/u at 12-month. 80% tx completion. ETP evidenced enhanced abstinence rates at 3-month and 12-month follow-up compared to STP, regardless of type of drug use.
  1. aDSM criteria used unless otherwise noted. bRAAT Random Assignment to Active Treatment, RAWC Random Assignment with Control, PPWC Pre-Post with Comparison Group (matched or otherwise). cAD Alcohol Dependence, CD Cocaine Dependence, SUD Substance Use Disorder. Articles included in the review utilized interview diagnosed screening materials (i.e., SCID) to identify drug abuse or dependence. Articles included in this table utilized a control group