ArticleAddiction (Abingdon, England)2019
What defines a clinically meaningful outcome in the treatment of substance use disorders: reductions in direct consequences of drug use or improvement in overall functioning?
Article in Addiction (Abingdon, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Substance Use Disorder Treatment Outcomes: Methodological Overview of Metrics and Criteria.International journal of methods in psychiatric research · 2025Pooled it
- A Descriptive Review and Meta-Regression Study of Demographic and Study Context Factors in US Clinical Trials of Cognitive Behavioral Interventions for Alcohol or Other Drug Use.Substance use & misuse · 2024Pooled it
- Interim opioid agonist treatment for opioid addiction: a systematic review.Harm reduction journal · 2022Pooled it
- Combined Pharmacotherapy and Cognitive Behavioral Therapy for Adults With Alcohol or Substance Use Disorders: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition.Journal of consulting and clinical psychology · 2019Pooled it
- Technology-Delivered Cognitive-Behavioral Interventions for Alcohol Use: A Meta-Analysis.Alcoholism, clinical and experimental research · 2019Pooled it
- Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead.Neuroscience and biobehavioral reviews · 2019Pooled it
- Behavioral Therapy as an Adjunct to Buprenorphine Treatment for Opioid Use Disorder: A Secondary Analysis of 4 Randomized Clinical Trials.JAMA network open · 2025Trial
- Examining cocaine use reductions and long-term outcomes in two clinical trials of continuing care for cocaine dependence.Journal of substance use and addiction treatment · 2024Trial
- The impact of spiritual well-being and social support on substance use treatment outcomes within a sample of predominantly Black/African American adults.Journal of substance use and addiction treatment · 2024Trial
- Evaluating cannabis use risk reduction as an alternative clinical outcome for cannabis use disorder.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2022Trial
- Characterizing cannabis use reduction and change in functioning during treatment: Initial steps on the path to new clinical endpoints.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2022Trial
- Changes in DSM criteria following a culturally-adapted computerized CBT for Spanish-speaking individuals with substance use disorders.Journal of substance abuse treatment · 2020Trial
- The Identification of Pretreatment Trajectories of Alcohol Use and Their Relationship to Treatment Outcome in Men and Women With Alcohol Use Disorder.Alcoholism, clinical and experimental research · 2019Trial
- Comparative effectiveness of social-contextual treatments for improving substance-related problems among Black adults: An individual-level data synthesis.Addiction (Abingdon, England) · 2026Article
- More Than a Symptom Count: Measuring Functioning in Alcohol Use Disorder With the Life Stress Interview.Journal of studies on alcohol and drugs · 2026Article
- The measurement of harm reduction goals and outcomes for substance use: Current state and future directions.Journal of prevention and health promotion · 2026Article
- Pharmacotherapy for Cannabis Use Disorder: Preclinical and Clinical Models.Current topics in behavioral neurosciences · 2026Review
- Substance use negatively impacts change in reinforcement during the year following substance use treatment.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2025Article
- Psychometric Evaluation of the Dutch Version of the Substance Use Recovery Evaluator (SURE-NL).European addiction research · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundSustained abstinence is currently the only accepted end-point for pharmacotherapy trials for most substance use disorders (SUD), with the exception of alcohol. Despite recent efforts, the identification of a non-abstinence alternative as a clinically meaningful end-point for drug use trials has been elusive. ARGUMENT AND ANALYSIS: The current standard for establishing a clinically meaningful outcome in SUD trials is to demonstrate that a reduction in drug use is associated with improvement in long-term functioning, but data indicate relatively weak associations between drug use and various psychosocial problem domains. This may be because assessments used most commonly to measure an individual's functioning do not specify whether aspects of functioning are a direct consequence of drug use. The acceptance of a non-abstinence-based end-point for alcohol use disorder trials was supported in part through associations with reductions in alcohol-related consequences, although measures designed to assess the direct consequences of drug use are rarely included in drug treatment efficacy trials.
conclusionsThe field of substance use disorders should include measures of negative psychosocial and health consequences of drug use, as opposed to overall functioning, in the effort to establish meaningful non-abstinence-based end-points.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.