Achieving Drug and Alcohol Abstinence Among Recently Incarcerated Homeless Women: A Randomized Controlled Trial Comparing Dialectical Behavioral Therapy-Case Management With a Health Promotion Program.
Adeline M Nyamathi, Sanghyuk S Shin, Jolene Smeltzer and 5 others
PMID 29095374WHAT IT FOUND
Among recently incarcerated homeless women, DBT-CM increased six-month drug abstinence compared with health promotion (65.5% vs 48.3%).
Alcohol abstinence also favoured DBT-CM. The combined drug and alcohol outcome did not favour DBT-CM.
Key findings
01At six months, drug abstinence was 65.5% (38/58) in DBT-CM and 48.3% (28/58) in health promotion, and the increase was greater in DBT-CM (OR 2.60; 95% CI 1.04 to 6.53; p = .04).
02DBT-CM participants were more likely to become or remain alcohol-abstinent during the study period than health promotion participants (OR 3.12; 95% CI 1.24 to 7.85; p = .02).
03The difference in combined drug and alcohol abstinence was not significant (OR 2.39; 95% CI 0.92 to 6.23; p = .07).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The primary analysis used 58 participants in each group. The primary analysis was complete case, and multiple imputation did not reach significance for any outcome. The intervention was a package of group sessions, one-on-one sessions, referrals, and ongoing contact, so the contribution of any single component cannot be separated. The sample was limited to adult homeless women in Southern California who were on probation or parole. Race/ethnicity was imbalanced between groups and was a confounder; more Black participants were in DBT-CM (44.6% vs 36.9%), and Black, Latina, and other race/ethnicity were associated with lower odds of abstinence.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude DBT-CM is proven for all substance-use outcomes. Combined drug and alcohol abstinence did not reach significance (OR 2.39; 95% CI 0.92 to 6.23; p = .07), and multiple imputation found no significant difference for any outcome.