This study will test a text-delivered intervention designed to reduce risk for opioid misuse with adolescents and their parent or primary caregiver. The overall goal is to test the efficacy of text-message (SMS) delivered Peer Network Counseling (PNC-txt) integrated with Trauma counseling (T) and parenting support (P). A randomized clinical trial of PNC-txt +TP compared to a Wait-List control condition to determine the efficacy of the intervention in reducing risk for opioid misuse.
The accuracy of young adults' perceptions of friends' cannabis and alcohol use: Challenging the false consensus theory
Background: Understanding the complex influence of peers on young adult substance use is an important component of intervention research and is challenging methodologically. The false consensus theory suggests that individual perceptions of peer substance use are biased, such that individual’s falsely attribute their own substance use behaviors onto their peers.
Methods: The current study tested this theory with 39 young adults with a mean age of 20 who met cannabis use disorder criteria. Index participants recruited three of their close friends for a sample of 156. Index participants reported their past 30-day cannabis and alcohol use, and their perceptions of their friends’ use. Indexes’ friends also reported their use of cannabis and alcohol.
Results: Results indicated that index participants were very accurate in their perceptions of the frequency of their friends’ cannabis (r = .84, p <0.01) and alcohol (r = .78, p <0.01) use. Simple linear regression models predicted friends’ actual cannabis and alcohol use based on indexes’ perceptions of friends’ use, controlling for indexes’ substance use. Indexes’ perceptions of friends’ cannabis use strongly predicted friend’s actual use (β = 0.80, p <0.01, adj-R2 = 0.67). Indexes’ perceptions of friends’ alcohol use also predicted friends’ actual use (Î² = 0.66, p <0.01, adj-R2 = 0.62). Indexes own substance use did not predict peer use in both models.
Conclusions: Results challenge the false consensus theory, demonstrating the accuracy of young adults’ knowledge of their friends substance use, indicating that perceptions are more predictive than individual use for determining the frequency of peer substance use.
Young adults' perceptions of acceptability and effectiveness of a text message-delivered treatment for cannabis use disorder
Introduction: Often surface-level treatment satisfaction data are collected during clinical trials but collecting in-depth qualitative data from intervention participants can lead to a better understanding of the mechanisms of change and identifying aspects of an intervention that could be improved.
Methods: Data were collected to examine cannabis use and treatment satisfaction information from young adults (ages 18-25) who had recently taken part in a randomized controlled trial of a text message-based intervention for problematic cannabis use. The survey included questions designed to determine general treatment satisfaction, post-study changes in use, and to gather feedback about potential improvements to the program.
Results: Nearly all (93%) respondents found PNC-Text to be helpful, with text message content being the most commonly endorsed helpful component (53%), followed by supportive “boost” messages (37%). Intervention texts specific to craving and current use resulted in 63.3% of the sample reporting heightened awareness of their use, and almost half (40%) reported a better understanding of problematic. Fifty percent of those who participated in the study reported that, when using cannabis, they use less than they did prior to the intervention. Seventy percent of respondents stated that it was helpful to answer questions about their friend group and nearly one-quarter of participants decreased the amount of time spent with “unhealthy” friends.
Conclusions: These findings provide encouraging evidence for the potential effectiveness of text-based counseling for problematic cannabis use. Furthermore, participants generally provided positive feedback on their experience with the program and indicated that it helped reduce their cannabis use.
Who responds best to text-delivered cannabis use disorder treatment? A randomized clinical trial with young adults
Young adults ages 18 to 25 have the highest percentage (5%) of cannabis use disorder (CUD) among all age groups, yet only 1.2% received illicit drug treatment in the last year. Because this population is in need of creative approaches for treatment engagement, we tested Peer Network Counseling-txt (PNC-txt), a four-week, automated text-delivered cannabis treatment that focuses on close peer relations with 96 treatment seeking young adults. Participants meeting CUD criteria were randomized to PNC-txt, or assessment only control condition and followed for 3- months. At 3-months, the PNC-txt group reduced number of heavy cannabis-use days and relationship problems due to cannabis use compared to controls. Sub-group analyses were conducted with cases having more and fewer CUD symptoms than the full sample. For cases with fewer symptoms, but not for those with more, PNC-txt reduced past 30-day use, urges to use, memory problems, and relationship problems due to cannabis use compared to controls. Unexpectedly, the control group improved their ability to control urges to use cannabis more than the PNC-txt group. Treatment satisfaction data from the full sample indicated that participants thought the intervention texts helped them reduce or manage their cannabis use and increased their understanding of the negative relational effects associated with ongoing cannabis use. Findings provide evidence of the efficacy of PNC-txt in treating CUD in young adults, support clinically targeting peer relations, and suggest that PNC-txt may be most helpful for those with mild to moderate CUD severity.
Remote biochemical verification of tobacco use: Reducing costs and improving methodological rigor with mailed oral cotinine swabs
Introduction: Multi-site tobacco cessation trials could benefit from methods of biochemically verifying tobacco use without face-to-face interaction with participants. To the authors’ knowledge, there have been no previous studies examining the predictive validity of oral fluid swabs for the detection of cotinine levels among tobacco users, with samples collected off-site and mailed for on-site interpretation.
Methods: Tobacco users were recruited through an online survey and participants who met the initial eligibility criteria were invited to take part. Those who elected to enroll provided two positive iScreen Oral Fluid Device (OFD) cotinine test samples during an in-office visit. One sample was used as a control and stored in a temperature-regulated location, while the other was mailed from one of ten surrounding counties. Mailing method and time from collection to mailing were varied, and results were assessed against control samples.
Results: Twenty tobacco users enrolled in the study. Participants ranged in age from 18 to 31 (M = 16.45, SD = 1.54). Several types of tobacco use were reported, with electronic cigarettes the most commonly reported product. None of the mailed sample interpretations changed from pre- to post-mailing, with up to twenty-one days from sample collection to results confirmation.
Conclusions: Results indicate that the use of mailed oral swabs may be a cost-effective and reliable option for the detection of cotinine in tobacco users when in-person collection is not feasible. Test result interpretations were found to be unchanged after mailing, and after extended post-collection time gaps.