Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders
Background Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD....
Gespeichert in:
| Veröffentlicht in: | Alcoholism, clinical and experimental research clinical and experimental research, 2022-10, Vol.46 (10), p.1865-1874 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1874 |
|---|---|
| container_issue | 10 |
| container_start_page | 1865 |
| container_title | Alcoholism, clinical and experimental research |
| container_volume | 46 |
| creator | Maddox‐Rooper, Taylor R. Sklioutouskaya‐Lopez, Kristiana Sturgill, Trenton Fresch, Caroline Clements, Charles W. Lamichhane, Rajan Egleton, Richard Davies, Todd H. |
| description | Background
Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD. Whereas cortisol levels reflect physiological responses to stress, patients' cortisol levels during recovery from an SUD may serve as biomarkers for stressors that result in poor treatment outcomes, including early discontinuation of treatment. However, further exploration of the relationship between patients' cortisol levels and their treatment outcomes is needed for this approach to be clinically useful.
Methods
We enrolled participants from an abstinence‐based, male‐only, residential alcohol and drug recovery program to examine the relationship between salivary cortisol, stress exposure, ACEs, and treatment retention.
Results
Participants who remained in the program |
| doi_str_mv | 10.1111/acer.14913 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2726146755</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2726146755</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3933-fc34a4b44d9e86c76ab5bc058ae6ba5affcdf197d71e1dd865b61cb8cced8d2f3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EokvhwgMgS9xQ09qbxMkeq1WBSpUqoXKOxvaYdcnGiyfZdm88Ao_Fc_AkzHZbjvjiyzff_JpfiLdanWp-Z-Awn-pqoctnYqbrUhVq3jTPxUzpqi6MUu2ReEV0q5SqWmNeiqPSKG2qxszE78thhO8ogQiJ1jiMJFOQBH3cQt5Jl_IYKfUnkqa8xZ3MSJs0MHwiYfAS_BYzoXSr2PtVSl7i_QZzxMEhScgP5uQijOjlXRxXLHCJZ3YsdMyQjAObJFga47Af-_PzlwVifMwI4z6S3OT0LcNahpR5jElgTk6813O47DnCa_EiQE_45vE_Fl8_XtwsPxdX158ul-dXhSsXZVkEV1ZQ2aryC2yNawzY2jpVt4DGQg0hOB_0ovGNRu19a2prtLMtR_Wtn4fyWLw_eDnTjwlp7G7TlAde2c2budGVaeqaqQ8HyuVElDF0mxzXfNBOq25fWrcvrXsojeF3j8rJrtH_Q59aYkAfgLvY4-4_qu58efHlIP0LnV-qvA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2726146755</pqid></control><display><type>article</type><title>Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Maddox‐Rooper, Taylor R. ; Sklioutouskaya‐Lopez, Kristiana ; Sturgill, Trenton ; Fresch, Caroline ; Clements, Charles W. ; Lamichhane, Rajan ; Egleton, Richard ; Davies, Todd H.</creator><creatorcontrib>Maddox‐Rooper, Taylor R. ; Sklioutouskaya‐Lopez, Kristiana ; Sturgill, Trenton ; Fresch, Caroline ; Clements, Charles W. ; Lamichhane, Rajan ; Egleton, Richard ; Davies, Todd H.</creatorcontrib><description>Background
Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD. Whereas cortisol levels reflect physiological responses to stress, patients' cortisol levels during recovery from an SUD may serve as biomarkers for stressors that result in poor treatment outcomes, including early discontinuation of treatment. However, further exploration of the relationship between patients' cortisol levels and their treatment outcomes is needed for this approach to be clinically useful.
Methods
We enrolled participants from an abstinence‐based, male‐only, residential alcohol and drug recovery program to examine the relationship between salivary cortisol, stress exposure, ACEs, and treatment retention.
Results
Participants who remained in the program <90 days had significantly higher initial cortisol levels than those who remained ≥90 days (0.62 ± 0.074 μg/dl vs. 0.36 ± 0.037 μg/dl). Kaplan–Meier curves differed significantly when we grouped participants according to whether their cortisol level was below or above the overall average of 0.49 ± 0.044 μg/dl, with the median numbers of days before discontinuing being 110 and 60, respectively. A Cox proportional hazards model indicated that elevated salivary cortisol (with increases in μg/dl), marital/relationship status, and adverse childhood experiences (ACEs) score correlated significantly with hazards of discontinuing the program (hazard ratios for the three factors were 3.49, 2.39, and 1.50, respectively).
Discussion
Cortisol level may predict, at least partially, SUD treatment program retention regardless of individuals' numerous confounding factors or the substance used. If this approach is validated, it could enable providers to consider patients' cortisol levels at the time of admission to treatment to facilitate their retention in treatment and thereby enhance their recovery.
Salivary cortisol levels, self‐report survey responses, and Adverse Childhood Experiences were recorded upon intake into an abstinence‐based recovery program to identify factors that associated with early attrition from the program. The study also showed that higher cortisol levels correlated with premature treatment discontinuation as did key survey responses, specific ACEs, and total ACE score also correlated with early attrition. Detecting these factors, particularly the biologic marker, may enable proactive resource allocation for more effective SUD treatment.</description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1111/acer.14913</identifier><identifier>PMID: 36016476</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Abstinence ; ACEs ; Adverse Childhood Experiences ; Alcoholism ; Childhood ; Children ; Clinical outcomes ; Confounding (Statistics) ; Cortisol ; Drug use ; functional outcomes ; Hormones ; Humans ; Hydrocortisone ; Male ; Patients ; Recovery (Medical) ; Retention ; Stress ; Substance abuse treatment ; Substance use ; Substance use disorder ; Substance-Related Disorders - therapy ; SUD ; Surveys and Questionnaires</subject><ispartof>Alcoholism, clinical and experimental research, 2022-10, Vol.46 (10), p.1865-1874</ispartof><rights>2022 Research Society on Alcoholism.</rights><rights>2022 Research Society on Alcoholism</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3933-fc34a4b44d9e86c76ab5bc058ae6ba5affcdf197d71e1dd865b61cb8cced8d2f3</citedby><cites>FETCH-LOGICAL-c3933-fc34a4b44d9e86c76ab5bc058ae6ba5affcdf197d71e1dd865b61cb8cced8d2f3</cites><orcidid>0000-0002-9090-6257</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Facer.14913$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Facer.14913$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36016476$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maddox‐Rooper, Taylor R.</creatorcontrib><creatorcontrib>Sklioutouskaya‐Lopez, Kristiana</creatorcontrib><creatorcontrib>Sturgill, Trenton</creatorcontrib><creatorcontrib>Fresch, Caroline</creatorcontrib><creatorcontrib>Clements, Charles W.</creatorcontrib><creatorcontrib>Lamichhane, Rajan</creatorcontrib><creatorcontrib>Egleton, Richard</creatorcontrib><creatorcontrib>Davies, Todd H.</creatorcontrib><title>Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description>Background
Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD. Whereas cortisol levels reflect physiological responses to stress, patients' cortisol levels during recovery from an SUD may serve as biomarkers for stressors that result in poor treatment outcomes, including early discontinuation of treatment. However, further exploration of the relationship between patients' cortisol levels and their treatment outcomes is needed for this approach to be clinically useful.
Methods
We enrolled participants from an abstinence‐based, male‐only, residential alcohol and drug recovery program to examine the relationship between salivary cortisol, stress exposure, ACEs, and treatment retention.
Results
Participants who remained in the program <90 days had significantly higher initial cortisol levels than those who remained ≥90 days (0.62 ± 0.074 μg/dl vs. 0.36 ± 0.037 μg/dl). Kaplan–Meier curves differed significantly when we grouped participants according to whether their cortisol level was below or above the overall average of 0.49 ± 0.044 μg/dl, with the median numbers of days before discontinuing being 110 and 60, respectively. A Cox proportional hazards model indicated that elevated salivary cortisol (with increases in μg/dl), marital/relationship status, and adverse childhood experiences (ACEs) score correlated significantly with hazards of discontinuing the program (hazard ratios for the three factors were 3.49, 2.39, and 1.50, respectively).
Discussion
Cortisol level may predict, at least partially, SUD treatment program retention regardless of individuals' numerous confounding factors or the substance used. If this approach is validated, it could enable providers to consider patients' cortisol levels at the time of admission to treatment to facilitate their retention in treatment and thereby enhance their recovery.
Salivary cortisol levels, self‐report survey responses, and Adverse Childhood Experiences were recorded upon intake into an abstinence‐based recovery program to identify factors that associated with early attrition from the program. The study also showed that higher cortisol levels correlated with premature treatment discontinuation as did key survey responses, specific ACEs, and total ACE score also correlated with early attrition. Detecting these factors, particularly the biologic marker, may enable proactive resource allocation for more effective SUD treatment.</description><subject>Abstinence</subject><subject>ACEs</subject><subject>Adverse Childhood Experiences</subject><subject>Alcoholism</subject><subject>Childhood</subject><subject>Children</subject><subject>Clinical outcomes</subject><subject>Confounding (Statistics)</subject><subject>Cortisol</subject><subject>Drug use</subject><subject>functional outcomes</subject><subject>Hormones</subject><subject>Humans</subject><subject>Hydrocortisone</subject><subject>Male</subject><subject>Patients</subject><subject>Recovery (Medical)</subject><subject>Retention</subject><subject>Stress</subject><subject>Substance abuse treatment</subject><subject>Substance use</subject><subject>Substance use disorder</subject><subject>Substance-Related Disorders - therapy</subject><subject>SUD</subject><subject>Surveys and Questionnaires</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhwgMgS9xQ09qbxMkeq1WBSpUqoXKOxvaYdcnGiyfZdm88Ao_Fc_AkzHZbjvjiyzff_JpfiLdanWp-Z-Awn-pqoctnYqbrUhVq3jTPxUzpqi6MUu2ReEV0q5SqWmNeiqPSKG2qxszE78thhO8ogQiJ1jiMJFOQBH3cQt5Jl_IYKfUnkqa8xZ3MSJs0MHwiYfAS_BYzoXSr2PtVSl7i_QZzxMEhScgP5uQijOjlXRxXLHCJZ3YsdMyQjAObJFga47Af-_PzlwVifMwI4z6S3OT0LcNahpR5jElgTk6813O47DnCa_EiQE_45vE_Fl8_XtwsPxdX158ul-dXhSsXZVkEV1ZQ2aryC2yNawzY2jpVt4DGQg0hOB_0ovGNRu19a2prtLMtR_Wtn4fyWLw_eDnTjwlp7G7TlAde2c2budGVaeqaqQ8HyuVElDF0mxzXfNBOq25fWrcvrXsojeF3j8rJrtH_Q59aYkAfgLvY4-4_qu58efHlIP0LnV-qvA</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Maddox‐Rooper, Taylor R.</creator><creator>Sklioutouskaya‐Lopez, Kristiana</creator><creator>Sturgill, Trenton</creator><creator>Fresch, Caroline</creator><creator>Clements, Charles W.</creator><creator>Lamichhane, Rajan</creator><creator>Egleton, Richard</creator><creator>Davies, Todd H.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K7.</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0002-9090-6257</orcidid></search><sort><creationdate>202210</creationdate><title>Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders</title><author>Maddox‐Rooper, Taylor R. ; Sklioutouskaya‐Lopez, Kristiana ; Sturgill, Trenton ; Fresch, Caroline ; Clements, Charles W. ; Lamichhane, Rajan ; Egleton, Richard ; Davies, Todd H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3933-fc34a4b44d9e86c76ab5bc058ae6ba5affcdf197d71e1dd865b61cb8cced8d2f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abstinence</topic><topic>ACEs</topic><topic>Adverse Childhood Experiences</topic><topic>Alcoholism</topic><topic>Childhood</topic><topic>Children</topic><topic>Clinical outcomes</topic><topic>Confounding (Statistics)</topic><topic>Cortisol</topic><topic>Drug use</topic><topic>functional outcomes</topic><topic>Hormones</topic><topic>Humans</topic><topic>Hydrocortisone</topic><topic>Male</topic><topic>Patients</topic><topic>Recovery (Medical)</topic><topic>Retention</topic><topic>Stress</topic><topic>Substance abuse treatment</topic><topic>Substance use</topic><topic>Substance use disorder</topic><topic>Substance-Related Disorders - therapy</topic><topic>SUD</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maddox‐Rooper, Taylor R.</creatorcontrib><creatorcontrib>Sklioutouskaya‐Lopez, Kristiana</creatorcontrib><creatorcontrib>Sturgill, Trenton</creatorcontrib><creatorcontrib>Fresch, Caroline</creatorcontrib><creatorcontrib>Clements, Charles W.</creatorcontrib><creatorcontrib>Lamichhane, Rajan</creatorcontrib><creatorcontrib>Egleton, Richard</creatorcontrib><creatorcontrib>Davies, Todd H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maddox‐Rooper, Taylor R.</au><au>Sklioutouskaya‐Lopez, Kristiana</au><au>Sturgill, Trenton</au><au>Fresch, Caroline</au><au>Clements, Charles W.</au><au>Lamichhane, Rajan</au><au>Egleton, Richard</au><au>Davies, Todd H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2022-10</date><risdate>2022</risdate><volume>46</volume><issue>10</issue><spage>1865</spage><epage>1874</epage><pages>1865-1874</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><abstract>Background
Connecting patients to treatment for a substance use disorder (SUD) that satisfies their needs is often complicated by confounding factors. A reliable measurement of patients' underlying stress level may be helpful because it often reflects many of the same confounders as their SUD. Whereas cortisol levels reflect physiological responses to stress, patients' cortisol levels during recovery from an SUD may serve as biomarkers for stressors that result in poor treatment outcomes, including early discontinuation of treatment. However, further exploration of the relationship between patients' cortisol levels and their treatment outcomes is needed for this approach to be clinically useful.
Methods
We enrolled participants from an abstinence‐based, male‐only, residential alcohol and drug recovery program to examine the relationship between salivary cortisol, stress exposure, ACEs, and treatment retention.
Results
Participants who remained in the program <90 days had significantly higher initial cortisol levels than those who remained ≥90 days (0.62 ± 0.074 μg/dl vs. 0.36 ± 0.037 μg/dl). Kaplan–Meier curves differed significantly when we grouped participants according to whether their cortisol level was below or above the overall average of 0.49 ± 0.044 μg/dl, with the median numbers of days before discontinuing being 110 and 60, respectively. A Cox proportional hazards model indicated that elevated salivary cortisol (with increases in μg/dl), marital/relationship status, and adverse childhood experiences (ACEs) score correlated significantly with hazards of discontinuing the program (hazard ratios for the three factors were 3.49, 2.39, and 1.50, respectively).
Discussion
Cortisol level may predict, at least partially, SUD treatment program retention regardless of individuals' numerous confounding factors or the substance used. If this approach is validated, it could enable providers to consider patients' cortisol levels at the time of admission to treatment to facilitate their retention in treatment and thereby enhance their recovery.
Salivary cortisol levels, self‐report survey responses, and Adverse Childhood Experiences were recorded upon intake into an abstinence‐based recovery program to identify factors that associated with early attrition from the program. The study also showed that higher cortisol levels correlated with premature treatment discontinuation as did key survey responses, specific ACEs, and total ACE score also correlated with early attrition. Detecting these factors, particularly the biologic marker, may enable proactive resource allocation for more effective SUD treatment.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36016476</pmid><doi>10.1111/acer.14913</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9090-6257</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0145-6008 |
| ispartof | Alcoholism, clinical and experimental research, 2022-10, Vol.46 (10), p.1865-1874 |
| issn | 0145-6008 1530-0277 |
| language | eng |
| recordid | cdi_proquest_journals_2726146755 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Abstinence ACEs Adverse Childhood Experiences Alcoholism Childhood Children Clinical outcomes Confounding (Statistics) Cortisol Drug use functional outcomes Hormones Humans Hydrocortisone Male Patients Recovery (Medical) Retention Stress Substance abuse treatment Substance use Substance use disorder Substance-Related Disorders - therapy SUD Surveys and Questionnaires |
| title | Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T17%3A22%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intake%20assessments%20of%20salivary%20cortisol,%20survey%20responses,%20and%20adverse%20childhood%20experiences%20are%20associated%20with%20recovery%20success%20in%20an%20abstinence%E2%80%90based%20treatment%20program%20for%20substance%20use%20disorders&rft.jtitle=Alcoholism,%20clinical%20and%20experimental%20research&rft.au=Maddox%E2%80%90Rooper,%20Taylor%20R.&rft.date=2022-10&rft.volume=46&rft.issue=10&rft.spage=1865&rft.epage=1874&rft.pages=1865-1874&rft.issn=0145-6008&rft.eissn=1530-0277&rft_id=info:doi/10.1111/acer.14913&rft_dat=%3Cproquest_cross%3E2726146755%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2726146755&rft_id=info:pmid/36016476&rfr_iscdi=true |