Can persons with a history of multiple addiction treatment episodes and chronic relapse benefit from technology-delivered behavior therapy?

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e111 Conclusions: In a diverse young adult sample with low SES, experience of past year food insecurity was associated with both current and former cigarette use. This association persisted after controlling for demographic, behavioral, and psychological correlates of smoking. The association between food insecurity and cigarette smoking among socioeconomically disadvantaged young adultswarrants greater attention given thedisproportionately high rates of smoking in this group. Financial support: NIDA T32 DA007250, P50 DA09253. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.306 Medical marijuana laws and annual opioid analgesic sales in the United States June H. Kim2, Julian Santaella1, Magdalena Cerda1, Silvia S. Martins1 1 Epidemiology, Columbia University, New York City, NY, United States 2 Epidemilogy, Mailman School of Public Health, New York, NY, United States Aims: To date, twenty-three states have enacted some type of medical marijuana legislation (MML), and more states may soon pass similar legislation. Concurrently, the epidemic of prescription opiate overdoses has recently shown signs of decline. It has been hypothesized that the increased availability of medical marijuana has provided a viable substitute for opioids in the treatment of chronic pain, resulting in fewer overdose deaths. This study assesseswhether stateMMLs are associatedwith actual opiate use, as measured by annual state opioid sales for the years 1999–2001. Methods: Annual opioid sales for 1999–2011 were culled from the Automation of Reports and Consolidated Orders System (ARCOS), compiled by theDrug Enforcement Administration (DEA). This data includes annual sales of oxycodone, hydromorphone, hydrocodone, meperdine, and morphine to pharmacies, hospitals and practitioners by state. Morphine equivalent doses (MED) per 100,000 residents were calculated for each state-year observation. States were classified as having a MML based on the date the law became effective. Mixed models with a fixed effect for year and a random effect for state were used to estimate differences in the (natural log) average MED rate for states with and without MML by year and across years, while also taking into account state and year specific prescription opioid policies/regulations and unemployment rates. Results: For both states with and without MML, the mean MED increased from 1999 to 2011 (25,267mg vs. 23,067.5mg and 89,114.3mg vs. 89,956.1mg, respectively). After controlling for this statistically increasing annual trend in MED (ˇ =0.12, tvalue =60.5, p-value <0.0001), a one percent reduction in annual opiate sales was observed for each additional year a MML was in effect (ˇ =−0.01, t-value =−3.17, p-value =0.0016). Conclusions: These findings suggest that medical marijuana laws are significantly associated with reduced prescription opioid sales at the state level. Further research is warranted. Financial support: NIDA grants T32DA031099 and R01DA037866. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.307 Can persons with a history of multiple addiction treatment episodes and chronic relapse benefit from technology-delivered behavior therapy? Sunny J. Kim, Lisa A. Marsch Psychiatry, Dartmouth College, Lebanon, NH, United