Objective: This study examines sociodemographic and clinical characteristics, as a function of primary substance of abuse, among clients approached, screened, and assessed for eligibility in a 10-site effectiveness trial of a Web-based psychosocial intervention for substance use disorders. Consistent with the design of effectiveness trials, eligibility criteria were broad and exclusion criteria minimal; thus, the recruited sample may be viewed as relatively representative of patients seeking treatment throughout the United States.
Methods: χ2 tests for categorical variables and F tests for continuous variables were used to analyze demographic, substance use, physical and mental health, and sexual risk data collected at screening and baseline; pairwise comparisons between primary substance subgroups for baseline data were conducted if the test statistic P value was 0.01 or less.
Results: Few participants expressed disinterest in the study at screening because of the computer-assisted intervention. A diverse sample of substance users completed baseline and were enrolled: 22.9% marijuana; 21.7% opiates; 20.9% alcohol; 20.5% cocaine; and 13.9% stimulants users. Marijuana users demonstrated the greatest differences across primary substances: they were younger, less likely to be married or attend 12-step meetings, and more likely to be in treatment as a result of criminal justice involvement. All patients, even marijuana users, reported comparable rates of co-occurring mental health disorders and sexual risk and substantial rates of polysubstance use disorders.
Conclusions: Primary substance of abuse may be a less important indicator of overall severity compared with co-occurring disorders and other factors common across treatment seekers, further demonstrating the need for integrated treatment services and care and comprehensive pretreatment assessment.
From the Department of Psychiatry (ANCC, EVN), New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York; Department of Psychiatry and Behavioral Health (ANCC), St Luke's Roosevelt Hospital Center, New York, NY; Department of Psychiatry and Behavioral Sciences (EAM), Medical University of South Carolina, Clinical Neuroscience Division, Charleston; Department of Psychiatry (MCH), Columbia University College of Physicians and Surgeons, New York, NY; New York State Psychiatric Institute (ET), New York; Northshore—Long Island Jewish Health System (BG), Glen Oaks, NY; and HARBEL Prevention and Recovery Center (PQS), Baltimore, MD.
Send correspondence and reprint request to Aimee N.C. Campbell, PhD, Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, 1051 Riverside Dr, Box 120, Room 3732, New York, NY 10032. E-mail: firstname.lastname@example.org.
Supported by grants from the National Drug Abuse Treatment Clinical Trials Network, National Institute on Drug Abuse (NIDA): U10 DA13035 (Nunes; Rotrosen), U10 DA15831 (Carroll; Weiss), U10 DA013034 (Stitzer; Schwartz), U10 DA013732 (Winhusen), U10 DA013720 (Szapocznik; Metsch), U10 DA020024 (Trivedi), U10 DA015815 (McCarty; Sorensen), U10 DA01304W5 (Ling), and U10 DA013714 (Donovan; Roll). Additional grant support was provided by NIDA K24 DA022412 (Nunes). Staff from NIDA's Center for the Clinical Trials Network provided input on study design.
Portions of this data were presented in a poster at the 74th Annual Meeting of The College on Problems of Drug Dependence, June 2012, Palm Springs, CA.
Dr Nunes served on the Lilly Advisory Board (completed 2012) and receives medication for a research study from Alkermes/Cephalon, Inc. The authors declare no additional conflicts of interests.
Received February 19, 2013
Accepted May 30, 2013