ORCID Profile
0000-0002-8330-0441
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Publisher: Bloomsbury Publishing Plc
Date: 2023
Publisher: Wiley
Date: 29-05-2023
DOI: 10.1111/DAR.13691
Abstract: Contingency management (CM) is currently the most efficacious treatment for meth hetamine use, yet it is rarely available in routine care. We examined the viewpoints of people who use meth hetamine on CM as a potential treatment for meth hetamine use disorder. Semi‐structured qualitative interviews with 30 Australians aged 18 years or older who had used meth hetamine at least weekly in the past 6 months. Participants reported overall positive attitudes towards CM as a potential treatment option for meth hetamine use disorder. However, there was need for greater flexibility in meeting participant treatment goals (e.g., reduced use or complete abstinence), with particular concern about the viability of initiating abstinence, both in terms of the sufficiency of the initial financial incentive and managing withdrawal symptoms. There was strong interest in the use of digital technologies to provide remote CM, particularly around the convenience and flexibility this offered. Despite this, participants remained keen to access adjunctive treatment and support services but stressed that engagement with these additional services should not be mandatory. Marketing of CM will need to address preconceptions about drug‐testing used in abstinence‐based CM being punitive (especially urine testing) and its connotations with criminal justice interventions. Positive attitudes towards CM bode well for potential uptake should CM be made available in routine clinical practice. However, there is a need to adapt CM to ensure it is feasible and attractive to people who are seeking treatment for meth hetamine use disorder.
Publisher: Wiley
Date: 04-05-2023
DOI: 10.1111/ADD.16200
Abstract: Studies often rely upon self‐report and biological testing methods for measuring illicit drug use, although evidence for their agreement is limited to specific populations and self‐report instruments. We aimed to examine comprehensively the evidence for agreement between self‐reported and biologically measured illicit drug use among all major illicit drug classes, biological indicators, populations and settings. We systematically searched peer‐reviewed databases (Medline, Embase and PsycINFO) and grey literature. Included studies reported 2 × 2 table counts or agreement estimates comparing self‐reported and biologically measured use published up to March 2022. With biological results considered to be the reference standard and use of random‐effect regression models, we evaluated pooled estimates for overall agreement (primary outcome), sensitivity, specificity, false omission rates (proportion reporting no use that test positive) and false discovery rates (proportion reporting use that test negative) by drug class, potential consequences attached to self‐report (i.e. work, legal or treatment impacts) and time‐frame of use. Heterogeneity was assessed by inspecting forest plots. From 7924 studies, we extracted data from 207 eligible studies. Overall agreement ranged from good to excellent ( 0.79). False omission rates were generally low, while false discovery rates varied by setting. Specificity was generally high but sensitivity varied by drug, s le type and setting. Self‐report in clinical trials and situations of no consequences was generally reliable. For urine, recent (i.e. past 1–4 days) self‐report produced lower sensitivity and false discovery rates than past month. Agreement was higher in studies that informed participants biological testing would occur (diagnostic odds ratio = 2.91, 95% confidence interval = 1.25–6.78). The main source of bias was biological assessments (51% studies). While there are limitations associated with self‐report and biological testing to measure illicit drug use, overall agreement between the two methods is high, suggesting both provide good measures of illicit drug use. Recommended methods of biological testing are more likely to provide reliable measures of recent use if there are problems with self‐disclosure.
No related grants have been discovered for Zachary Wilkinson.