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Selected Publications
2018 |
Ashford, Robert D; Curtis, Brenda; Brown, Austin M In: Harm Reduct J, vol. 15, no. 1, pp. 52, 2018, ISSN: 1477-7517 (Electronic); 1477-7517 (Linking). @article{Ashford2018,BACKGROUND: Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effective in improving SUD outcomes, as well as improving the engagement and effectiveness of harm reduction programs. METHODS: This study provides an initial evaluation of a hybrid recovery community organization providing PRSS as well as peer-based harm reduction services via a syringe exchange program. Administrative data collected during normal operations of the Missouri Network for Opiate Reform and Recovery were analyzed using Pearson chi-square tests and Monte Carlo chi-square tests. RESULTS: Intravenous substance-using participants (N = 417) had an average of 2.14 engagements (SD = 2.59) with the program. Over the evaluation period, a range of 5345-8995 sterile syringes were provided, with a range of 600-1530 used syringes collected. Participant housing status, criminal justice status, and previous health diagnosis were all significantly related to whether they had multiple engagements. CONCLUSIONS: Results suggest that recovery community organizations are well situated and staffed to also provide harm reduction services, such as syringe exchange programs. Given the relationship between engagement and participant housing, criminal justice status, and previous health diagnosis, recommendations for service delivery include additional education and outreach for homeless, justice-involved, LatinX, and LGBTQ+ identifying individuals. |
Ashford, Robert D; Brown, Austin M; Curtis, Brenda Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias. Journal Article In: Drug Alcohol Depend, vol. 189, pp. 131-138, 2018, ISSN: 1879-0046 (Electronic); 0376-8716 (Linking). @article{Ashford2018c,BACKGROUND: The general public, treatment professionals, and healthcare professionals have been found to exhibit an explicit negative bias towards substance use and individuals with a substance use disorder (SUD). Terms such as "substance abuser" and "opioid addict" have shown to elicit greater negative explicit bias. However, other common terms have yet to be empirically studied. METHODS: 1,288 participants were recruited from ResearchMatch. Participants were assigned into one of seven groups with different hypothesized stigmatizing and non-stigmatizing terms. Participants completed a Go/No Association Task (GNAT) and vignette-based social distance scale. Repeated-measures ANOVAs were used to analyze the GNAT results, and one-way ANOVAs were used to analyze vignette results. RESULTS: The terms "substance abuser", "addict", "alcoholic", and "opioid addict", were strongly associated with the negative and significantly different from the positive counterterms. "Relapse" and "Recurrence of Use" were strongly associated with the negative; however, the strength of the "recurrence of use" positive association was higher and significantly different from the "relapse" positive association. "Pharmacotherapy" was strongly associated with the positive and significantly different than "medication-assisted treatment". Both "medication-assisted recovery" and "long-term recovery" were strongly associated with the positive, and significantly different from the negative association. CONCLUSIONS: Results support calls to cease use of the terms "addict", "alcoholic", "opioid addict", and "substance abuser". Additionally, it is suggested that "recurrence of use" and "pharmacotherapy" be used for their overall positive benefits. Both "medication-assisted recovery" and "long-term recovery" are positive terms and can be used when applicable without promoting stigma. |
Curtis, Brenda L; Lookatch, Samantha J; Ramo, Danielle E; McKay, James R; Feinn, Richard S; Kranzler, Henry R In: Alcohol Clin Exp Res, vol. 42, no. 6, pp. 978–986, 2018, ISSN: 1530-0277 (Electronic); 0145-6008 (Linking). @article{Curtis2018bb,Despite the pervasive use of social media by young adults, there is comparatively little known about whether, and how, engagement in social media influences this group's drinking patterns and risk of alcohol-related problems. We examined the relations between young adults' alcohol-related social media engagement (defined as the posting, liking, commenting, and viewing of alcohol-related social media content) and their drinking behavior and problems. We conducted a systematic review and meta-analysis of studies evaluating the association of alcohol consumption and alcohol-related problems with alcohol-related social media engagement. Summary baseline variables regarding the social media platform used (e.g., Facebook and Twitter), social media measures assessed (e.g., number of alcohol photographs posted), alcohol measures (e.g., Alcohol Use Disorders Identification Test and Timeline Follow back Interview), and the number of time points at which data were collected were extracted from each published study. We used the Q statistic to examine heterogeneity in the correlations between alcohol-related social media engagement and both drinking behavior and alcohol-related problems. Because there was significant heterogeneity, we used a random-effects model to evaluate the difference from zero of the weighted aggregate correlations. We used metaregression with study characteristics as moderators to test for moderators of the observed heterogeneity. Following screening, 19 articles met inclusion criteria for the meta-analysis. The primary findings indicated a statistically significant relationship and moderate effect sizes between alcohol-related social media engagement and both alcohol consumption (r = 0.36, 95% CI: 0.29 to 0.44, p < 0.001) and alcohol-related problems (r = 0.37, 95% CI: 0.21 to 0.51, p < 0.001). There was significant heterogeneity among studies. Two significant predictors of heterogeneity were (i) whether there was joint measurement of alcohol-related social media engagement and drinking behavior or these were measured on different occasions and (ii) whether measurements were taken by self-report or observation of social media engagement. We found moderate-sized effects across the 19 studies: Greater alcohol-related social media engagement was correlated with both greater self-reported drinking and alcohol-related problems. Further research to determine the causal direction of these associations could provide opportunities for social media-based interventions with young drinkers aimed at reducing alcohol consumption and alcohol-related adverse consequences. |
Curtis, Brenda; Giorgi, Salvatore; Buffone, Anneke E K; Ungar, Lyle H; Ashford, Robert D; Hemmons, Jessie; Summers, Dan; Hamilton, Casey; Schwartz, H Andrew Can Twitter be used to predict county excessive alcohol consumption rates? Journal Article In: PLoS One, vol. 13, no. 4, pp. e0194290, 2018, ISSN: 1932-6203 (Electronic); 1932-6203 (Linking). @article{Curtis2018b,OBJECTIVES: The current study analyzes a large set of Twitter data from 1,384 US counties to determine whether excessive alcohol consumption rates can be predicted by the words being posted from each county. METHODS: Data from over 138 million county-level tweets were analyzed using predictive modeling, differential language analysis, and mediating language analysis. RESULTS: Twitter language data captures cross-sectional patterns of excessive alcohol consumption beyond that of sociodemographic factors (e.g. age, gender, race, income, education), and can be used to accurately predict rates of excessive alcohol consumption. Additionally, mediation analysis found that Twitter topics (e.g. 'ready gettin leave') can explain much of the variance associated between socioeconomics and excessive alcohol consumption. CONCLUSIONS: Twitter data can be used to predict public health concerns such as excessive drinking. Using mediation analysis in conjunction with predictive modeling allows for a high portion of the variance associated with socioeconomic status to be explained. |
Ashford, Robert D; Lynch, Kevin; Curtis, Brenda Technology and Social Media Use Among Patients Enrolled in Outpatient Addiction Treatment Programs: Cross-Sectional Survey Study. Journal Article In: J Med Internet Res, vol. 20, no. 3, pp. e84, 2018, ISSN: 1438-8871 (Electronic); 1438-8871 (Linking). @article{Ashford2018b,BACKGROUND: Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment. OBJECTIVE: The aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery. METHODS: We conducted a cross-sectional survey of patients in 4 intensive outpatient substance use disorder treatment facilities in Philadelphia, PA, USA. Logistic regressions were used to examine associations among variables. RESULTS: Survey participants (N=259) were mostly male (72.9%, 188/259), African American (62.9%, 163/259), with annual incomes less than US $10,000 (62.5%, 161/259), and averaged 39 (SD 12.24) years of age. The vast majority of participants (93.8%, 243/259) owned a mobile phone and about 64.1% (166/259) owned a mobile phone with app capabilities, of which 85.1% (207/243) accessed the internet mainly through their mobile phone. There were no significant differences in age, gender, ethnicity, or socio-economic status by computer usage, internet usage, number of times participants changed their phone, type of mobile phone contract, or whether participants had unlimited calling plans. The sample was grouped into 3 age groups (Millennials, Generation Xers, and Baby Boomers). The rates of having a social media account differed across these 3 age groups with significant differences between Baby Boomers and both Generation Xers and Millennials (P<.001 in each case). Among participants with a social media account (73.6%, 190/259), most (76.1%, 144/190) reported using it daily and nearly all (98.2%, 186/190) used Facebook. Nearly half of participants (47.4%, 90/190) reported viewing content on social media that triggered substance cravings and an equal percentage reported being exposed to recovery information on social media. There was a significant difference in rates of reporting viewing recovery information on social media across the 3 age groups with Baby Boomers reporting higher rates than Millennials (P<.001). The majority of respondents (70.1%, 181/259) said they would prefer to use a relapse prevention app on their phone or receive SMS (short message service) relapse prevention text messages (72.3%, 186/259), and nearly half (49.1%, 127/259) expressed an interest in receiving support by allowing social media accounts to be monitored as a relapse prevention technique. CONCLUSIONS: To our knowledge, this is the first and largest study examining the online behavior and preferences regarding technology-based substance use disorder treatment interventions in a population of patients enrolled in community outpatient treatment programs. Patients were generally receptive to using relapse prevention apps and text messaging interventions and a substantial proportion supported social media surveillance tools. However, the design of technology-based interventions remains as many participants have monthly telephone plans which may limit continuity. |
Ashford, Robert D.; Brown, Austin M.; Eisenhart, Emily; Thompson-Heller, Anne; Curtis, Brenda What we know about students in recovery: meta-synthesis of collegiate recovery programs, 2000-2017 Journal Article In: Addiction Research & Theory, vol. 26, no. 5, pp. 405-413, 2018. @article{Ashford2018d,As a relatively new field of practice, collegiate recovery programs (CRP), have used a practice-informed approach as a means of establishing best practices and pedagogy. While research on collegiate recovery programs and populations of students in recovery is growing, much of the qualitative studies have yet to be synthesized into a useful organizing matrix. This study utilizes meta-synthesis design to explore the leading qualitative research on student experiences in collegiate recovery. From this synthesis, researchers identified six metaphors from ten included studies from 2000–2017. The six metaphors of social connectivity, recovery supports, drop-in recovery centers, internalized feelings, coping mechanisms, and conflict of recovery/student status, support much of the preexisting practices and provide a critical framework for future program design, service delivery, and research. |
2016 |
Feinn, Richard; Curtis, Brenda; Kranzler, Henry R Balancing risk and benefit in heavy drinkers treated with topiramate: implications for personalized care. Journal Article In: J Clin Psychiatry, vol. 77, no. 3, pp. e278-82, 2016, ISSN: 1555-2101 (Electronic); 0160-6689 (Linking). @article{Feinn2019,BACKGROUND: Despite topiramate's ability to reduce heavy drinking, its adverse effects may limit its clinical utility. METHOD: To evaluate the risks and benefits of topiramate, we reanalyzed data from a completed trial of the medication in 138 heavy drinkers whose goal was to reduce their drinking to safe levels. We used the number of patients who had no heavy drinking days during the last 4 weeks of treatment to calculate topiramate's number needed to treat (NNT). To balance the risks and benefits of topiramate, we adjusted the NNT using 2 different levels of adverse event severity: moderate or greater (NNT-AEmod+) and severe or greater (NNT-AEsev+). This measure helps to guide the clinical use of topiramate in heavy drinkers by incorporating both its beneficial and adverse effects in a single measure. Because a polymorphism (rs2832407) in the gene encoding a kainate receptor subunit appears to moderate topiramate's effects in heavy drinkers, we repeated the analyses based on rs2832407 genotype (C-homozygote vs A-allele carrier) in the European American subsample (n = 122). RESULTS: Overall, the NNT for topiramate was 5.29, the NNT-AEmod+ was 7.52, and the NNT-AEsev+ was 6.12. Among European Americans with the rs2832407*CC genotype, the NNT was 2.28, the NNT-AEmod+ was 2.63, and the NNT-AEsev+ was 2.56. In contrast, for rs2832407*A-allele carriers, the NNT was 180.00, the NNT-AEmod+ was 322.16, and the NNT-AEsev+ was 217.45. CONCLUSIONS: In this sample of heavy drinkers, topiramate had a clinically important treatment effect that was most evident in European Americans with the rs2832407*CC genotype. In that group, in particular, it had a robust treatment effect, even when adjusted for adverse events. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00626925. |
2015 |
Meyers, Kathleen; Kaynak, Ovgu; Bresani, Elena; Curtis, Brenda; McNamara, Ashley; Brownfield, Kristine; Kirby, Kimberly C The availability and depiction of synthetic cathinones (bath salts) on the Internet: Do online suppliers employ features to maximize purchases? Journal Article In: Int J Drug Policy, vol. 26, no. 7, pp. 670-4, 2015, ISSN: 1873-4758 (Electronic); 0955-3959 (Linking). @article{Meyers2015,BACKGROUND: "Bath salts", a derivative of cathinone, a naturally occurring beta-ketone amphetamine analogue found in the leaves of the khat (Catha edulis) plant, is a potent class of designer drugs associated with significant medical and psychiatric consequences. They are commonly used among 20-29 year olds, a group with easy access to the Internet and an inclination to purchase online. Therefore, the Internet has the potential to play a significant role in the distribution and associated consequences of these "legal highs". METHODS: Google searches were used to determine bath salts availability on retail websites and how different search terms affected the proportion of retail websites obtained. Retail websites were reviewed by two independent raters who examined content with a focus on characteristics that increase the likelihood of online sales. RESULTS: Of the 250 websites found, 31 were unique retail websites. Most retail website hits resulted when a product name was used as the search term. The top three countries hosting retail websites were registered in the United States (n=14; 45%), Germany (n=7; 23%), and the United Kingdom (n=3; 10%). These online drug suppliers provided considerable information and purchasing choice about a variety of synthetic cathinones, legitimized their sites by using recognizable images, online chat features, and mainstream payment and shipping methods, and employed characteristics that promote online purchases. CONCLUSION: Online designer drug suppliers use sophisticated methods to market unregulated products to consumers. The international community has taken diverse approaches to address designer drugs: legislative bans, harm reduction approaches, an interim regulated legal market. Multifaceted efforts that target bath salt users, suppliers, and emergency/poison control entities are critical to comprehensively address bath salt ingestion and its consequences. |
Curtis, Brenda; Alanis-Hirsch, Kelly; Kaynak, Ovgu; Cacciola, John; Meyers, Kathy; McLellan, Anthony Thomas Using Web searches to track interest in synthetic cannabinoids (a/k/a 'herbal incense'). Journal Article In: Drug Alcohol Rev, vol. 34, no. 1, pp. 105-108, 2015, ISBN: 1465-3362 (Electronic); 0959-5236 (Linking). @article{Curtis2015,INTRODUCTION AND AIMS: This article reports a content analysis of Internet websites related to an emerging designer drug, synthetic cannabinoids. The number of synthetic cannabinoids searchers in the USA has steadily increased from November 2008 to November 2011. DESIGN AND METHODS: To determine the information available on the Internet in relation to synthetic cannabinoids, sites were identified using the Google search engine and the search term 'herbal incense'. The first 100 consecutive sites were visited and classified by two coders. The websites were evaluated for type of content (retail, information, news, other). US unique monthly visitor data were examined for the top 10 retail sites, and these sites were coded for the quality of information available regarding the legality of synthetic cannabinoids sale and use. RESULTS: The Google search yielded 2,730,000 sites for 'herbal incense' (for comparison of search terms: 'synthetic marijuana', 1,170,000; 'K2 Spice', 247,000; and 'synthetic weed', 122,000). Moreover, in the Google search, 87% of the sites were retail sites, 5% news, 4% informational and 4% non-synthetic cannabinoid sites. DISCUSSION AND CONCLUSIONS: Many tools found within Google free services hold promise in providing a technique to identify emerging drug markets. We recommend continued surveillance of the Internet using the online tools presented in this brief report by both drug researchers and policy-makers to identify the emerging trends in synthetic drugs' availability and interest. |
2014 |
Curtis, Brenda L Social networking and online recruiting for HIV research: ethical challenges. Journal Article In: J Empir Res Hum Res Ethics, vol. 9, no. 1, pp. 58-70, 2014, ISSN: 1556-2654 (Electronic); 1556-2646 (Linking). @article{Curtis2014,Social networking sites and online advertising organizations provide HIV/AIDS researchers access to target populations, often reaching difficult-to-reach populations. However, this benefit to researchers raises many issues for the protections of prospective research participants. Traditional recruitment procedures have involved straightforward transactions between the researchers and prospective participants; online recruitment is a more complex and indirect form of communication involving many parties engaged in the collecting, aggregating, and storing of research participant data. Thus, increased access to online data has challenged the adequacy of current and established procedures for participants' protections, such as informed consent and privacy/confidentiality. Internet-based HIV/AIDS research recruitment and its ethical challenges are described, and research participant safeguards and best practices are outlined. |
Curtis, Brenda L; McLellan, A Thomas; Gabellini, Beth N Translating SBIRT to public school settings: an initial test of feasibility. Journal Article In: J Subst Abuse Treat, vol. 46, no. 1, pp. 15-21, 2014, ISSN: 1873-6483 (Electronic); 0740-5472 (Linking). @article{Curtis2014b,Public schools are not traditional locations where screening, brief motivational counseling intervention and referral to treatment (SBIRT) are provided. This translational research study aimed to test the feasibility of conducting SBIRT in two urban New York schools and to examine its economic sustainability. In Spring 2012, 248 students were screened during non-academic classes: 42% of them (n=105) reported substance use (versus 28% reported in school-wide, paper anonymous survey). All but one of the positively screened students voluntarily accepted one or more brief intervention sessions and two students were referred to treatment. This school-based SBIRT model did not interfere with academic activities, was feasible to implement, and was attractive to students, teachers and administration. The data offer clear indication that further effectiveness testing is warranted and potentially valuable, however the sustainability of this model was not supported due to our lack of obtaining insurance information, authorization and reimbursement. |
