***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aims To determine whether the additional interventions to st and ard care are cost-effective in addressing cocaine and alcohol abuse at 4 months ( 4 M ) and 12 months ( 12 M ) from baseline . Method We conducted a cost-effectiveness analysis of a r and omized controlled trial with three arms : ( 1 ) NIDA 's St and ard intervention ( SI ) ; ( 2 ) SI plus a Well Woman Exam ( WWE ) ; and , ( 3 ) SI , WWE , plus four Educational Sessions ( 4ES ) . Results To obtain an additional cocaine abstainer , WWE compared to SI cost $ 7,223 at 4 M and $ 3,611 at 12 M. Per additional alcohol abstainer , WWE compared to SI cost $ 3,611 and $ 7,223 at 4 M and 12 M , respectively . At 12 M , 4ES was dominated ( more costly and less effective ) by WWE for abstinence outcomes . Conclusions To our knowledge , this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women . Depending on primary outcomes sought and priorities of policy makers , peer-delivered interventions can be a cost-effective way to address the needs of this growing , underserved population . Trial Registration Clinical Trials.gov 82 Ss were studied in a comparative evaluation of a behavioral vs supportive treatment for illegal drug use .  Behavioral treatment included stimulus control , urge , control , contracting/family support and competing response procedures for an average of 19 sessions . 37 % of Ss in the behavioral condition were drug-free at 2 months , 54 % at 6 months , and 65 % at 12 months vs 20 + /- 6 % for the alternative treatment during all 12 months . The behavioral treatment was more effective across sex , age , educational level , marital status and type of drug ( hard-drugs , cocaine , and marijuana ) . Greater improvement for this condition was also noted on measures of employment/school attendance , family relationships , depression , institutionalization and alcohol use Background Alcohol misuse is a significant international public health problem . Screening and brief intervention ( SBI ) in primary care reduces alcohol consumption by about 15 – 30 % , sustained over 12 months in hazardous or harmful drinkers but implementation has proved difficult leading to growing interest in exploring the effectiveness of SBI in other setting s , including the workplace . Computerised interventions for alcohol misuse can be as effective as traditional face-to-face interventions and may have advantages , including anonymity , convenience and availability . Methods / design Individually r and omised controlled trial to determine the effectiveness and cost-effectiveness of offering online screening and brief intervention for alcohol misuse in a workplace . Participants : adults ( aged 18 or over ) employed by participating employers scoring 5 or more on a three item screen for alcohol misuse ( the AUDIT-C ) indicating possible hazardous or harmful alcohol consumption , recruited through the offer of an online health check providing screening for a range of health behaviours with personalised feedback . Participants who accept the health check and score 5 or more on the alcohol screen will be r and omised to receiving immediate feedback on their alcohol consumption and access to an online intervention offering support in reducing alcohol consumption ( Down Your Drink ) or delayed feedback and access to Down Your Drink after completion of follow-up data at three months . All employees who take the online health check will receive personalised feedback on other screened health behaviours including diet , physical activity , smoking , and body mass index . The primary outcome is alcohol consumption in the past week at three months ; secondary outcomes are the AUDIT , EQ-5D , days off work , number and duration of hospital admissions , costs and use of the intervention . A sample size of 1,472 participants ( 736 in each arm ) provides 90 % power with 5 % significance to determine a 20 % reduction in alcohol consumption . Outcomes between groups at three months will be compared following the intention to treat principle and economic analyses will follow NICE guidance . Discussion This innovative design avoids recruitment bias by not mentioning alcohol in the invitation and avoids reactivity of assessment by not collecting baseline data on alcohol consumption AIMS This study aim ed to determine the relative effectiveness of 12 months of interim methadone ( IM ; supervised methadone with emergency counseling only for the first 4 months of treatment ) , st and ard methadone treatment ( SM ; with routine counseling ) and restored methadone treatment ( RM : routine counseling with smaller case-loads ) . DESIGN A r and omized controlled trial was conducted comparing IM , SM and RM treatment . IM lasted for 4 months , after which participants were transferred to SM . SETTING The study was conducted in two methadone treatment programs in Baltimore , MD , USA . PARTICIPANTS The study included 230 adult methadone patients newly admitted through waiting-lists . MEASUREMENTS We administered the Addiction Severity Index and a supplemental question naire  at baseline , 4 and 12 months post- baseline . Measurements included retention in treatment , self-reported days of heroin and cocaine use , criminal behavior and arrests and urine tests for heroin and cocaine metabolites . FINDINGS At 12 months , on an intent-to-treat basis , there were no significant differences in retention in treatment among the IM , SM and RM groups ( 60.6 % , 54.8 % and 37.0 % , respectively ) . Positive urine tests for the three groups declined significantly from baseline ( Ps < 0.001 and 0.003 , for heroin and cocaine metabolites , respectively ) but there were no significant group x time interactions for these measures . At least one arrest was reported by 30.6 % of the sample during the year , but there were no significant between-group effects . CONCLUSIONS Limited availability of drug counseling services should not be a barrier to providing supervised methadone to adults dependent on heroin -- at least for the first 4 months of treatment Interventions for alcohol- and substance-dependent adults with comorbid depressive disorders are needed , but few have been empirically tested . In a r and omized clinical trial of two psychotherapy interventions for these disorders , we examined whether initial focus of treatment was related to retention , substance use , and depression outcomes . Both interventions , integrated cognitive-behavioral therapy ( ICBT ; n = 105 ) and twelve-step facilitation  ( n = 92 ) , were delivered in group formats with entry points every 4 weeks at the beginning of three content-distinct modules . Entry module ( i.e. , initial treatment focus ) was not related to percentage days abstinent , proportion of the sample abstinent , or depression symptoms for either intervention . This was true at both 12 and 24 weeks postbaseline . Furthermore , attendance was similar for both treatments , regardless of initial treatment focus , with a single exception in the ICBT condition . Our findings support the use of modular formats with multiple or rotating entry points for psychotherapy group interventions BACKGROUND Few r and omised controlled trials have been aim ed specifically at substance use reduction among people with psychotic disorders . AIMS To investigate whether a 10-session intervention consisting of motivational interviewing and cognitive-behavioural therapy ( CBT ) was more efficacious than routine treatment in reducing substance use and improving symptomatology and general functioning . METHOD A community sample of people with a psychotic disorder and who reported hazardous alcohol , cannabis and /or amphetamine use during the preceding month was recruited . Participants were r and omly allocated to motivational interviewing/CBT ( n = 65 ) or treatment as usual ( n = 65 ) , and were assessed on multiple outcomes at baseline , 15 weeks , 6 months and 12 months . RESULTS There was a short-term improvement in depression and a similar trend with regard to cannabis use among participants who received the motivational interviewing/CBT intervention , together with effects on general functioning at 12 months . There was no differential benefit of the intervention on substance use at 12 months , except for a potentially clinical ly important effect on amphetamine use . CONCLUSIONS The motivational interviewing/CBT intervention was associated with modest improvements Smoking treatment for newly recovering drug and alcohol-dependent smokers in a residential rehabilitation program was examined . The r and omly assigned conditions ( n = 50 each ) were multicomponent smoking treatment ( MST ) , MST plus generalization training of smoking cessation to drug and alcohol cessation ( MST+G ) , or usual care ( UC ) .  Fifty participants who declined smoking treatment ( treatment refusers ) also were studied . Both treatment conditions achieved continuous smoking abstinence rates ( MST : 12 % , MST+G : 10 % , at 12-month follow-up ) that were significantly higher than in the UC condition ( 0 % ) . The MST condition had a continuous drug and alcohol abstinence rate that was significantly higher than that of the MST+G condition ( 40 % vs. 20 % at 12-month follow-up ) although neither differed significantly from that of the UC condition ( 33 % ) . These results support the feasibility of smoking treatment for this population and provide information regarding appropriate treatment components OBJECTIVES We compared the effects of 2 interventions on alcohol use , use of a new syringe at last injection , and condom use at last sexual encounter in a community sample of injection drug users . METHODS Between 2003 and 2006 , 851 out-of-treatment injection drug users were recruited in Raleigh , NC , and Durham , NC , through street outreach and were r and omly assigned to either a 6-session educational intervention or a 6-session motivational intervention . Intervention effects were examined at 6 and 12 months after enrollment . RESULTS In multiple logistic regression analyses adjusted for baseline alcohol use and HCV status , participants assigned to the motivational intervention were significantly less likely than were participants in the educational intervention to be drinking at the 6-month follow-up ( odds ratio = 0.67 ; 95 % confidence interval = 0.46 , 0.97 ) . There were no significant between-group differences in use of a new syringe at last injection or condom use at last sexual encounter at either follow-up . CONCLUSIONS Reducing alcohol use among persons with HCV may slow disease progression and provide important health benefits . Additional strategies are needed for slowing HCV disease progression until more effective HCV treatments are available Aim To develop and evaluate the comparative effectiveness of behavioural interventions of enhanced prevention counselling ( EPC ) and simple educational counselling ( SEC ) in reducing hepatitis C viral ( HCV ) infection in sero-negative injecting drug users ( IDU ) . Design R and omised controlled trial ( RCT ) of EPC intervention in comparison with simple educational counselling ( SEC ) . Setting SpecialisedDrug services in London and Surrey , United Kingdom . Participants and Measurements Ninety five IDUs were recruited and r and omised to receive EPC ( n = 43 ) or SEC ( n = 52 ) . Subjects were assessed at baseline using the Addiction Severity Index ( ASI ) , the Injecting Risk Question naire ( IRQ ) , and Drug Injecting Confidence Question naire ( DICQ ) . The primary outcome was measured by the rate of sero-conversion at 6 months and 12 months from baseline and by the ASI , IRQ and DICQ at 6 months from baseline . Hepatitis C testing was undertaken by the innovative test of the dried blood spot ( DBS ) test which increased the rate of testing by 4 fold compared to routine blood testing . Findings SeventyEighty two subjects ( 82 % ) out of the 95 recruited were followed up at 6 months and 62 ( 65 % ) were followed up at 12 months . On the primary outcome measure of the rate of seroconversion , 8 out of 62 patients followed-up at twelve months seroconverted , three in the EPC group and five in the SEC group , indicating incidence rates of 9.1 per 100 person years for the EPC group , 17.2 per 100 person years for the SEC group , and 12.9 per 100 person years for the cohort as a whole . Analysis of the secondary outcome measures on alcohol use , risk behaviour , psychological measures , quality of life , showed no significant differences between the EPC and the SEC groups . However , there were significant changes on a number of measures from baseline values indicating positive change for both groups . Conclusion We were not able to prove the efficacy of EPC in comparison with SEC in the prevention of hepatitis C in IDUs . This was related to low recruitment and retention rates of the participants . Moreover there was a low adherence rate to EPC . The study provided the benefits of developing and introducing behavioural interventions of the EPC and SEC and the DBS screening for Hepatitis C. Moreover the main lessons learnt were that piloting of a new intervention is a crucial first step before conducting pragmatic RCTs of psychological interventions in the field of addiction ; that an infrastructure and culture for psychosocial interventions is needed to enable applied research in the service environment , and research funding is needed for enabling the recruitment of dedicated trained therapists for the delivery of these interventions Background Despite the importance of heavy drinking and alcohol dependence among patients with opiate and cocaine dependence , few studies have evaluated specific interventions within this group . The aim of the present study was to evaluate the impact of screening with the Alcohol Use Disorders Identification Test ( AUDIT ) and of brief intervention ( BI ) on alcohol use in a sample of patients treated for opioid or cocaine dependence in a specialized outpatient clinic . Methods Adult out patients treated for opioid or cocaine dependence in Switzerl and were screened for excessive alcohol drinking and dependence with the AUDIT .  Patients with AUDIT  scores that indicated excess 
    Output:
    
Very little evidence exists that there is no difference in the effectiveness between different types of interventions and that brief interventions are not superior to assessment only or treatment as usual .