{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T18:26:31Z","timestamp":1783189591730,"version":"3.54.6"},"reference-count":101,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abstinence-based alcohol interventions are minimally desirable to and effective for chronically homeless individuals with alcohol dependence who have multimorbidity and high publicly funded service utilization and associated costs. Lower-barrier, patient-centered combined pharmacobehavioral interventions may more effectively treat this population. Harm reduction counseling involves a nonjudgmental, empathic style and patient-driven goal setting that requires neither abstinence nor use reduction. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving, is safe and effective for active drinkers, and may thereby support harm reduction goal setting. The aims of this 12-week, single-arm pilot were to initially document some aspects of feasibility, acceptability, and alcohol outcomes following XR-NTX administration and harm reduction counseling for chronically homeless individuals with alcohol dependence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were currently\/formerly chronically homeless, alcohol-dependent individuals ( N = 31) from 2 community-based agencies in the US Pacific Northwest. Measures included self-reported alcohol craving, quantity\/frequency, problems, and biomarkers (ethyl glucuronide [EtG], liver transaminases). XR-NTX and harm reduction counseling were administered monthly over the 3-month treatment course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 45 individuals approached, 43 were interested in participation. The first injection was received by 31 participants, and 24 complied with all study procedures. Participants reported the treatment was acceptable. Participants evinced decreases in alcohol craving (33%), typical (25%) and peak (34%) use, frequency (17%), problems (60%), and EtG from the baseline to the 12-week follow-up ( Ps &lt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>XR-NTX and harm reduction counseling are promising means of supporting reductions in alcohol use and alcohol-related harm among chronically homeless, alcohol-dependent individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1080\/08897077.2014.904838","type":"journal-article","created":{"date-parts":[[2014,4,29]],"date-time":"2014-04-29T16:05:33Z","timestamp":1398787533000},"page":"21-33","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Extended-Release Naltrexone and Harm Reduction Counseling for Chronically Homeless People with Alcohol Dependence"],"prefix":"10.1177","volume":"36","author":[{"given":"Susan E.","family":"Collins","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington\u2013Harborview Medical Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington\u2013Harborview Medical Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian F.","family":"Smart","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington\u2013Harborview Medical Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Saxon","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington\u2013Harborview Medical Center, Seattle, Washington, USA"},{"name":"VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel K.","family":"Malone","sequence":"additional","affiliation":[{"name":"Downtown Emergency Service Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Ron","family":"Jackson","sequence":"additional","affiliation":[{"name":"Evergreen Treatment Services, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Ries","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington\u2013Harborview Medical Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,1,1]]},"reference":[{"key":"bibr1-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050225"},{"key":"bibr2-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2004.02.004"},{"key":"bibr3-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1007\/s001270050262"},{"key":"bibr4-08897077.2014.904838","unstructured":"World Health Organization. Global Status Report on Alcohol and Health. Geneva, Switzerland: World Health Organization; 2011."},{"key":"bibr5-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-008-0371-8"},{"key":"bibr6-08897077.2014.904838","first-page":"229","volume":"164","author":"Hwang SW","year":"2001","journal-title":"CMAJ"},{"key":"bibr7-08897077.2014.904838","unstructured":"Homeless Emergency and Rapid Transition to Housing (HEARTH) ActHomeless Emergency and Rapid Transition to Housing (HEARTH) Act, S. 896\u201338(2009)."},{"key":"bibr8-08897077.2014.904838","first-page":"13","volume":"29","author":"Martens WH","year":"2001","journal-title":"Public Health Rev."},{"key":"bibr9-08897077.2014.904838","volume-title":"Dying Without Dignity: Homeless Deaths in Los Angeles County","author":"Hawke W","year":"2007"},{"key":"bibr10-08897077.2014.904838","volume-title":"Premature Mortality in Homeless Populations: A Review of the Literature","author":"O'Connell JJ.","year":"2005"},{"key":"bibr11-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4036"},{"key":"bibr12-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.414"},{"key":"bibr13-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.88.11.1610"},{"key":"bibr14-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200111000-00003"},{"key":"bibr15-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(98)00046-4"},{"key":"bibr16-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.1999.10471736"},{"key":"bibr17-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2011.07.010"},{"key":"bibr18-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2014.10.009"},{"key":"bibr19-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521-0391.2003.tb00547.x"},{"key":"bibr20-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4603(99)00018-0"},{"key":"bibr21-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(03)00026-6"},{"key":"bibr22-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/0376-8716(84)90033-4"},{"key":"bibr23-08897077.2014.904838","first-page":"25","volume":"22","author":"Becker HC","year":"1998","journal-title":"Alcohol Health Res World"},{"key":"bibr24-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1041350"},{"key":"bibr25-08897077.2014.904838","volume-title":"Dissertation. University of Toronto","author":"Svoboda T","year":"2006"},{"key":"bibr26-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300403"},{"key":"bibr27-08897077.2014.904838","first-page":"3","volume-title":"Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors","author":"Collins SE","year":"2011"},{"key":"bibr28-08897077.2014.904838","volume-title":"Housing First: The Pathways Model to End Homelessness for People With Mental Illness and Addiction","author":"Tsemberis S.","year":"2010"},{"key":"bibr29-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60928-2"},{"key":"bibr30-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60742-8"},{"key":"bibr31-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1080\/10826080600669579"},{"key":"bibr32-08897077.2014.904838","volume-title":"Brief Alcohol Screening and Intervention for College Students (BASICS): A Harm Reduction Approach","author":"Dimeff LA","year":"1999"},{"key":"bibr33-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2006.05.004"},{"key":"bibr34-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4603(96)00042-1"},{"key":"bibr35-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1995.tb01077.x"},{"key":"bibr36-08897077.2014.904838","first-page":"121","volume-title":"Motivational Interviewing: Helping People Change","author":"Miller WR","year":"2012"},{"key":"bibr37-08897077.2014.904838","unstructured":"National Institute on Alcohol Abuse and Alcoholism. Helping Patients Who Drink Too Much: A Clinician's Guide. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism; 2005. NIH publication no. 05-3769."},{"key":"bibr38-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb00820.x"},{"key":"bibr39-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(76)90013-9"},{"key":"bibr40-08897077.2014.904838","first-page":"873","volume":"131","author":"McIntosh MC","year":"1984","journal-title":"CMAJ"},{"key":"bibr41-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.3109\/10826088109038892"},{"key":"bibr42-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00019.x"},{"issue":"8","key":"bibr43-08897077.2014.904838","first-page":"CD005191","author":"McQueen J","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr44-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2009.00071.x"},{"key":"bibr45-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1177\/070674371205700604"},{"key":"bibr46-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2009.70.516"},{"issue":"3","key":"bibr47-08897077.2014.904838","first-page":"CD005032","author":"Ferri M","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr48-08897077.2014.904838","first-page":"S15","volume":"36","author":"Garbutt JC","year":"2009","journal-title":"J Subst Abuse Treat"},{"key":"bibr49-08897077.2014.904838","volume-title":"Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions","author":"Denning P","year":"2011"},{"key":"bibr50-08897077.2014.904838","volume-title":"Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems","author":"Tartarsky A.","year":"2002"},{"key":"bibr51-08897077.2014.904838","first-page":"49","volume-title":"Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors","author":"Marlatt GA","year":"1998"},{"key":"bibr52-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1080\/16066350500489170"},{"key":"bibr53-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.2174\/187152710790966704"},{"key":"bibr54-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/add.12238"},{"key":"bibr55-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820110045007"},{"key":"bibr56-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820110040006"},{"key":"bibr57-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1996.01830030039007"},{"key":"bibr58-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1177\/0269881107078308"},{"issue":"2","key":"bibr59-08897077.2014.904838","first-page":"CD001867","author":"Srisurapanont M","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr60-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000245566.52401.20"},{"issue":"12","key":"bibr61-08897077.2014.904838","first-page":"CD001867","author":"R\u00f6sner S","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr62-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.3109\/00952990.2013.796961"},{"key":"bibr63-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00763.x"},{"key":"bibr64-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1300\/J069v19n01_06"},{"key":"bibr65-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1997.01830200071010"},{"key":"bibr66-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2011.72.1012"},{"key":"bibr67-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1097\/01.ALC.0000130804.08397.29"},{"key":"bibr68-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.13.1617"},{"key":"bibr69-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2010.03.005"},{"key":"bibr70-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2012.08.012"},{"key":"bibr71-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1097\/jcp.0b013e31814ce50d"},{"key":"bibr72-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9562-9"},{"key":"bibr73-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2006.090209"},{"key":"bibr74-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2008.149989"},{"key":"bibr75-08897077.2014.904838","first-page":"S222","volume":"17","author":"Bryson W","year":"2011","journal-title":"Am J Manag Care"},{"key":"bibr76-08897077.2014.904838","first-page":"S222","volume":"17","author":"Baser O","year":"2011","journal-title":"Am J Manag Care"},{"key":"bibr77-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2012.763083"},{"key":"bibr78-08897077.2014.904838","volume-title":"Substance Abuse Treatment: What Works for Homeless People? A Review of the Literature","author":"Zerger S.","year":"2002"},{"key":"bibr79-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-10-67"},{"key":"bibr80-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2012.03.029"},{"key":"bibr81-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.8.966"},{"key":"bibr82-08897077.2014.904838","volume-title":"Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I\/P)","author":"First MB","year":"2002"},{"key":"bibr83-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-0357-5_3"},{"key":"bibr84-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.20132"},{"key":"bibr85-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2008.04.007"},{"key":"bibr86-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.15288\/jsas.2005.s15.157"},{"key":"bibr87-08897077.2014.904838","first-page":"343","volume":"22","author":"Levine J","year":"1986","journal-title":"Psychopharmacol Bull"},{"key":"bibr88-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/0740-5472(92)90062-S"},{"key":"bibr89-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1999.tb04349.x"},{"key":"bibr90-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1037\/e563232012-001"},{"key":"bibr91-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1046\/j.1359-6357.2003.00588.x"},{"key":"bibr92-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2007.01.025"},{"issue":"1","key":"bibr93-08897077.2014.904838","first-page":"16a","volume":"35","author":"Jones M","year":"2011","journal-title":"Alcohol Clin Exp Res"},{"key":"bibr94-08897077.2014.904838","volume-title":"Manual for Combining Naltrexone With BASICS for the Treatment of Heavy Alcohol Use in Young Adults","author":"O'Malley SS","year":"2006"},{"key":"bibr95-08897077.2014.904838","volume-title":"Medical Management Treatment Manual: A Clinical Research Guide for Medically Trained Clinicians Providing Pharmacotherapy as Part of a Treatment for Alcohol Dependence","author":"Pettinati HM","year":"2004"},{"key":"bibr96-08897077.2014.904838","volume-title":"Motivational Interviewing: Helping People Change","author":"Miller WR","year":"2012"},{"key":"bibr97-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.16.2152"},{"key":"bibr98-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2008.04.015"},{"key":"bibr99-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-009-9283-7"},{"key":"bibr100-08897077.2014.904838","volume-title":"Research Design in Clinical Psychology","author":"Kazdin AE.","year":"2003"},{"key":"bibr101-08897077.2014.904838","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00136408"}],"container-title":["Substance Abuse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2014.904838","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1080\/08897077.2014.904838","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2014.904838","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:44:46Z","timestamp":1777625086000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1080\/08897077.2014.904838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":101,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1080\/08897077.2014.904838"],"URL":"https:\/\/doi.org\/10.1080\/08897077.2014.904838","relation":{},"ISSN":["0889-7077","1547-0164"],"issn-type":[{"value":"0889-7077","type":"print"},{"value":"1547-0164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1]]}}}