1058. A Clinical Trial of a New Treatment for Drug Abuse by Veterans with SPMI
Alan S Bellack, PhD, VISN 5 Mental Illness Research, Education, and Clinical Center (MIRECC), ME Bennett, VISN 5 MIRECC, JS Gearon, VISN 5 MIRECC, CH Brown, VISN 5 MIRECC

Objectives: Drug and alcohol abuse by veterans with severe and persistent mental illness (SPMI) is one of the most significant problems facing the system. Lifetime prevalence rates exceed 50%, and substance abuse among SPMI veterans is associated with a host of deleterious medical, psychiatric, interpersonal, and legal consequences. We have been conducting a clinical trial to test a new, multifaceted treatment for substance abuse in SPMI patients: Behavioral Treatment for Substance Abuse in SPMI (BTSAS).

Methods: Veterans and non-veterans meeting criteria for SPMI and abuse of cocaine, opiates, or cannabinoids were randomly assigned to 6-months of treatment with either BTSAS, or Supportive Treatment in Addiction Recovery (STAR), a manualized treatment as usual.

Results: The preliminary outcome data are very promising. Compared to subjects receiving STAR, subjects in BTSAS had a significantly higher percentage of clean urines over the 6-months of treatment (M= 44% vs M=25%, with missed sessions counted as dirty), attended significantly more sessions (M=28.5 [out of 50] vs. M=20.3), and had significantly less attrition (M= 54.1% vs. 38.29%). A total of 31% of BTSAS subjects had at least one 8-week block of continuous abstinence compared to only 11% of subjects in STAR.

Conclusions: These results compare favorably to any other published study on this difficult to treat population.

Impact: If replicated, these data could have important implications for treatment of dually disordered veterans in VA. BTSAS is described in a detailed treatment manual, and it could have wide applicability throughout the system.