Europe PMC · 2026
Telehealth-Plus-mHealth Intervention for Young Adults With Cannabis Use Disorder: Protocol for a Pilot Randomized Controlled Trial.
Shrier LA, Palmer A, Parker S, Kossowsky J, Katz-Wise SL, Burke PJ, Milliren CE, Harris SK.
Background More than 5 million young adults in the United States meet criteria for cannabis use disorder (CUD), placing them at risk for adverse physical, psychiatric, and social outcomes. Most individuals with CUD do not receive treatment due to numerous barriers, including motivation, stigma, limited availability and accessibility of developmentally appropriate services, and competing demands for time and finances. A novel digital health intervention, Momentary Self-Monitoring and Feedback + Motivational Enhancement Therapy-Virtual (MOMENT-V), was developed and combines telehealth motivational enhancement therapy with mobile health ecological momentary intervention (EMI) to provide a fully remote brief intervention for CUD among young adults. Objective We describe the protocol for a parallel, 2-arm, pilot randomized controlled trial of MOMENT-V vs enhanced usual care (EUC) to evaluate intervention and trial feasibility in young adults with CUD recruited from primary care clinics. Methods We are inviting primary care patients, aged 18 to 26 years, to self-screen through clinic posters with QR codes, invitations from clinicians, and patient portal messages. Eligible patients (eg, Cannabis Use Disorder Identification Test-Revised score ≥12, cannabis use ≥3 days/week, and smartphone ownership; N=60) will be randomly assigned 1:1 to receive MOMENT-V or EUC. MOMENT-V will include 2 weekly sessions of motivational enhancement therapy via telehealth, then 2 weeks of mobile health EMI-mobile self-monitoring with messages following reports of personal triggers for use. EUC will include a brief meeting with a counselor to review cannabis use problems and provide substance use and mental health resources. Participants will be assessed via surveys and a timeline followback calendar interview at baseline, 3 weeks, 3 months, and 6 months, and by an interview at 6 months. Primary outcomes will include completion, EMI engagement, and acceptability as measures of intervention feasibility, and screening, eligibility, enrollment, and retention rates as measures of trial feasibility. Primary outcomes will be evaluated against a priori benchmarks. Secondary outcomes will include counselor adherence to motivational interviewing principles, therapeutic alliance, duration of study activities, barriers, facilitators, CUD symptoms, and amount of delta-9-tetrahydrocannabinol used in standard units for motivation to change cannabis use, psychological distress, cognitive function, and quality of life. We will also examine cannabis use frequency and problems resulting from cannabis use. For the quantitative analyses, we will use descriptive statistics, logistic regression, and generalized linear mixed effects modeling. For the qualitative analyses, we will use immersion/crystallization, template organizing style, and thematic analysis. Results Recruitment began in August 2025 and is anticipated to end in January 2027. Data collection is projected to be completed in July 2027. We plan to submit a manuscript describing the main outcomes in early 2028. Conclusions This study will provide data regarding the MOMENT-V digital health intervention and trial feasibility in anticipation of a fully powered efficacy trial in young adults with CUD who are being seen in primary care.
Europe PMC · 2026
Promoting self-change in cannabis use disorder: Results of a randomized controlled trial after one year.
Brazeau BW, Schluter MG, Stea JN, Kilborn ML, Hodgins DC.
Introduction Self-directed interventions may help close treatment gaps in cannabis use disorder (CUD), particularly for individuals who prefer minimal professional contact. We previously tested a paper-and-pencil workbook, with or without a single motivational interview (MI), in a three-arm randomized controlled trial. Methods Canadian adults with CUD were allocated to workbook plus MI (WMI), workbook only (WB), or delayed workbook treatment (DT). The current paper reports outcomes after 9 and 12 months as well as exploratory analyses on workbook usage. Trial outcomes included days and grams of cannabis use in the past month, distress, quality of life, and cannabis-related problems. Results The follow-up sample (N = 155) was 77% White and 54% female with a mean age of 32.1 years. Across the sample, all outcomes improved over time. However, the MI conferred additional benefit in terms of quicker reductions in cannabis use quantity, but not frequency or cannabis-related problems, relative to WB and DT. WB did not demonstrate greater improvements than DT, although the study was underpowered to detect modest effects. Concurrent treatment was accessed by 72% but not associated with outcomes. Engagement with the workbook declined over the follow-ups, although a meaningful subset continued regular use. Perceived workbook helpfulness correlated with perceived treatment success (r = 0.33). Within the WMI group, MI non-completers reported higher workbook frequency than completers, suggesting possible compensation for the missed MI. Conclusions Results support the durability of low-intensity, self-directed bibliotherapy for CUD when combined with a brief MI. These findings point to stepped-care applications while motivating research on mechanisms, subgroups, and engagement.
Europe PMC · 2026
Motivational interviewing for substance use among adults in low- and middle-income countries: A systematic review.
Adams AS, Williams T, Stein DJ, Sibeko G, Shoptaw S, Rollnick S.
Background Harmful substance use (HSU) poses a significant global health challenge, impacting social, economic, and healthcare systems. Low- and middle-income countries (LMICs) are particularly burdened as a result of limited infrastructure for managing substance-related issues. While evidence-based brief interventions like motivational interviewing (MI) are widely used in high-income countries, research on their effectiveness in LMICs is limited. Aim This systematic review aims to evaluate studies employing MI as part of interventions for adults with HSU in LMIC settings. Setting This review focused on studies within low- and middle-income countries which include settings characterised by constrained mental health resources, high treatment gaps for substance use disorders (SUDs), and diverse service delivery contexts. Methods Following Cochrane and PRISMA guidelines, we searched PubMed, EBSCOhost, Web of Science, Cochrane Library, clinicaltrials.gov and GSK Clinical Study Register for publications from 2010 to 2022. A narrative analysis was conducted, and the Joanna Briggs Institute Critical Appraisal Tools assessed study quality. Results Out of 518 publications, 11 studies from five countries met our inclusion criteria. Most were randomised controlled trials, with some using qualitative or mixed methods. The interventions targeted alcohol, opioids, and other drugs. Different strategies were used, including MI-blended with other interventions (such as cognitive-behavioural therapy, behavioural activation, and imaginal desensitisation) or using MI-informed approaches. Conclusion Overall, MI-informed interventions were shown to improve substance use outcomes in six of the 11 studies, with a significant reduction in substance use. However, further high-quality research with larger samples and rigorous designs is needed to strengthen the evidence base and address potential sources of bias. Contribution Findings suggest that MI-informed approaches, as a brief intervention, can improve substance use outcomes in resource-constrained environments within LMICs.
Europe PMC · 2026
Adolescent Substance Use Screening in the Emergency Department.
Sandelich S, Amanullah S, Barata I, Berg K, Brown K, Cheng T, Chimptazi C, Claudius I, Dietrich AM, Lin S, Ruttan T, Stoner M, Sulton C, Waseem M.
Adolescent substance use remains a major public health concern, and the emergency department (ED) represents a critical point of contact for identification and early intervention. Many adolescents rely on the ED as their primary or sole source of health care, making missed opportunities for screening particularly consequential. Although overall substance use rates among youth have stabilized or declined in recent years, drug-related mortality, especially from illicitly manufactured fentanyl, has risen sharply, highlighting the need for proactive detection and intervention. Professional organizations recommend universal, validated screening for substance use in adolescents, yet implementation in ED settings remains inconsistent due to workflow constraints, confidentiality concerns, and limited provider training. Validated tools, such as the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) questionnaire, the screening to brief intervention (S2BI) tool, and the brief screener for tobacco, alcohol, and other drugs (BSTAD) tool, allow rapid, developmentally appropriate screening. They can be integrated into electronic health records (EHRs) or self-administered digital formats. Evidence suggests that electronic or kiosk-based screening increases disclosure and detection without adversely affecting throughput. Screening alone is insufficient; pairing detection with brief motivational interventions and facilitated referral to treatment improves short-term outcomes and linkage to care. However, follow-up rates remain suboptimal, underscoring the need for structured referral pathways, behavioral health integration, and technology-enabled supports such as text-based reminders or telehealth. Universal, developmentally tailored screening in the ED, combined with brief intervention and active linkage to outpatient care, offers a practical strategy to reduce substance-related morbidity and improve long-term outcomes for adolescents.
Europe PMC · 2026
Brief intervention can change the trajectory of youth substance use.
Charlebois S, Kelly S.
A fonte não publicou resumo para este artigo. O BETARUBI não abre o texto noutro site.
Europe PMC · 2026
WADD-SEPD Consensus on Psychological Treatment of Dual Disorders I: General Recommendations, Most Used Therapies, and Severe Mental Disorders.
Benito A, Jiménez-Murcia S, Tirado-Muñoz J, Adan A.
Background/Objectives : The treatment of dual disorders (DDs) must be comprehensive and multidisciplinary. There is evidence supporting the effectiveness of psychotherapy in their treatment. However, clinical guidelines, consensus statements, and reviews on the treatment of DDs typically devote considerably less space to psychological therapy than to pharmacological therapy. Therefore, this work aimed to synthesize the available evidence, recommendations, and clinical experience on the psychological treatment of DDs to reach a consensus. Methods : Two consensus methods were sequentially implemented: the nominal group technique and the Delphi method. Results: The first part of this consensus review encompassed a compilation of general recommendations for the psychological treatment of DDs, evidence on the efficacy of the most frequently used therapies, and recommendations for the psychological treatment of severe dual mental disorders. These disorders include schizophrenia and other psychotic disorders, bipolar disorders, depressive disorders, and obsessive compulsive disorders. Conclusions : (1) Psychological treatment is effective; (2) integrated psychological treatment is more effective; (3) motivational interviewing, cognitive behavioral therapy, and relapse prevention are the psychological interventions with the most supporting evidence; (4) the best alternative is multicomponent strategies; (5) the most frequently studied severe mental disorders are schizophrenia and depression; (6) for dual schizophrenia, motivational interviewing and integrated cognitive behavioral therapy combined with other components are recommended; (7) for dual depression, cognitive behavioral therapy with relapse prevention or motivational interviewing is recommended; (8) for dual bipolar disorder, group therapies with psychoeducation or relapse prevention and inclusion of the family, contingency management, and family intervention are recommended; (9) more empirical evidence is needed, especially for obsessive compulsive and schizoaffective disorders; and (10) more randomized clinical trials are needed to improve current methodological limitations.
Europe PMC · 2026
Implementing Screening, Brief Intervention, and Referral to Treatment in the Emergency Department: A Qualitative Evaluation of Impact and Challenges.
Perlmutter DL, Al-Shimari FH, Wyatt JG.
Background Emergency departments (EDs) serve as a critical point of care for individuals with unmet substance use disorder (SUD) treatment needs. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach designed to proactively identify and mitigate substance use risk. We sought the perspectives of individuals responsible for delivering ED-based SBIRT to better understand the impact on patients and ED processes and identify challenges in implementing SBIRT. Methods In-depth interviews were conducted with clinicians and supervisors (n = 9) involved in SBIRT delivery at 2 emergency departments in King County, Washington, United States. Thematic analysis was used. Results ED-based SBIRT has benefits to patients as well as other providers. SBIRT leverages teachable moments following substance-related injuries and emphasizes patient autonomy to provide a form of substance use care that would not otherwise be available in the ED. There are ancillary benefits to the ED, including improved interprofessional collaboration, increased capacity for substance use care, and perceived destigmatization among other healthcare providers. Persistent resource constraints-including limited reimbursement for core components of SBIRT and lack of access to many treatment options-were identified as challenges to implementation. Conclusions Reliable referral networks, integration of immediate treatment access, and sustained investment in staff training are critical to maximizing the benefits of SBIRT programs. While gaps in the behavioral health continuum continue to present challenges, SBIRT remains a vital intervention for connecting patients to care and shaping ED practices toward improved SUD outcomes. These findings are relevant for individuals responsible for implementing similar programs as well as implementation-focused researchers.
Europe PMC · 2026
Supporting desistance from crime and recovery from drug use with a patient-facing bidirectional eHealth tool: a case report.
Palanijafi S, Månflod J, Andersson K.
Background Simultaneous exit from both drug use and a criminal organization is a difficult and potentially dangerous process for the individual. Case presentation This case report describes the use of the eHealth tool Previct Drugs to support a 27-year-old Caucasian male with substance use disorder in exiting an organized crime gang and achieving both sobriety and a law-abiding lifestyle. The eHealth tool is a smartphone application that provides eye-scanning-based drug screening to promote sobriety, as well as cognitive behavioral therapy and motivational interviewing. A strong therapeutic alliance was rapidly established, supported by continuous insight into the individual's sobriety and mood through the eHealth tool. The individual used the system for 7 months. Conclusion Care could be delivered with precise timing when the individual signaled a need for support, preventing at least one relapse. According to caregiver estimates, use of the eHealth tool accelerated the process of achieving sobriety and exiting the criminal lifestyle by several months.
