
Ethan SahkerKyoto University | Kyodai · Graduate School of Medicine
Ethan Sahker
PhD
Substance use disorder treatment
About
49
Publications
12,705
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Introduction
My research investigates the substance use treatment pathway (access, success, and recovery). I conduct clinical epidemiology studies of substance use treatment to discover factors supporting successful treatment outcomes with consideration of health disparities and recovery capital. Currently, I am focused on improving access by advancing evidence-based brief intervention technologies in primary care.
Additional affiliations
Education
August 2013 - August 2019
Publications
Publications (49)
Background:
Regular/chronic drinking, defined by five or more drinks in one sitting on each of five or more occasions in the past 30 days, is a significant problem contributing to negative health outcomes, morbidity, and mortality. Regular/chronic and heavy episodic drinking largely goes undetected by primary care providers due to a lack of screen...
Background: Diagnostic and treatment gaps exist for those with substance use disorders (SUD). SUD diagnostics in treatment have been critically under-investigated. We investigated known diagnoses in US addiction treatment centres receiving state or federal funding.
Methods: Cross-sectional risk factor analysis of variables associated with known dia...
Background: Provider-evaluated substance use treatment completion and client-reported substance use improvement are standards in determining treatment success. The relationship between these two outcomes is anecdotally understood in practice. However, the relationship has not been empirically determined and factors related to provider/client confli...
Background
Black clients in substance use disorder (SUD) treatment are associated with the lowest successful completion and substance use reductions. More work is needed to identify specific factors that support successful recovery of Black clients.
Methods
Data from U.S. outpatient SUD treatment facilities receiving public funding from 2015-2019...
Background:
The efficacy of brief intervention (BI) for unhealthy drug use in outpatient medical care has not been sufficiently substantiated through meta-analysis despite its ongoing global delivery. This study aims to determine the efficacy of BI for unhealthy drug use and the expected length of effects, and describe subgroup analyses by outpati...
Objectives
Our objectives were to examine the magnitude of the proportion attributable to contextual effects (PCE), which shows what proportion of the treatment arm response can be achieved by the placebo arm across various interventions, and to examine PCE variability by outcome type and condition.
Design
We conducted a meta-epidemiological study...
Background: In double-blind randomized controlled trials (RCTs) of antidepressants, blinding can be broken due to the apparent side effects, and unsuccessful blinding can lead to overestimation of effect sizes. New generation antidepressants with less severe side effects may be less susceptible to broken blinding. However, successfulness of blindin...
Internationally, the prevalence of gambling disorder has been reported to be higher among homeless people than the general population; however, little is known about the factors associated with gambling disorder in this population. The present study aimed to investigate the prevalence of gambling disorder and its associated factors among homeless m...
The Japanese Big Five Scale Short Form (JBFS-SF), a 29-item self-report scale, has recently been used to measure the Big Five personality traits. However, the scale lacks psychometric validation. This study examined the validity and reliability of the JBFS-SF with data collected from 1,626 Japanese university students participating in a randomized...
Background:
Internet-based cognitive-behavioural therapy (iCBT) is effective for subthreshold depression. However, which skills provided in iCBT packages are more effective than others is unclear. Such knowledge can inform construction of more effective and efficient iCBT programmes.
Objective:
To examine the efficacy of five components of iCBT...
Objective Although mindfulness and self-compassion programs have been applied in clinical settings, no studies have reported their benefits for atopic dermatitis (AD). The aim of the study was to evaluate the feasibility and acceptability of an online group format of 8 weekly 90-minute sessions of a mindfulness and self-compassion program for adult...
Objective
The standardized mean difference (SMD) can be calculated from different mean differences (MDs) and standard deviations (SDs). This study aims to investigate how clinical trials calculated, reported and interpreted the SMD, and to examine the variation between different SMDs.
Study Design and Setting
We searched the PubMed for randomized...
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of internet-based cognitive behavioural therapy for preventing postnatal depression. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Objectives:
Few people can access psychotherapy for irritable bowel syndrome (IBS). Group cognitive-behavioral therapy (GCBT) may be efficient, but the evidence for its efficacy is weak and limited. We aimed to assess the efficacy and safety of GCBT with interoceptive exposure (GCBT-IE), a novel form of GCBT for drug-refractory IBS.
Methods:
A s...
Major depression is often a relapsing disorder. It is therefore important to start its treatment with therapies that maximize the chance of not only getting the patients well but also keeping them well. We examined the associations between initial treatments and sustained response by conducting a network meta-analysis of randomized controlled trial...
Cultural capital is a known factor supporting success in substance use disorder (SUD) treatment. We investigated Asian American and Pacific Islander (AAPI) State population metrics in relation to SUD treatment completion for US clients from 2006–2017 (N=5,404,374). Metrics that may signify greater available cultural capital were State AAPI Percenta...
Objective
This study compares three major elements of evidence-based medicine (EBM) practices, namely evidence synthesis, clinical practice guidelines (CPGs) and real-world prescriptions in the US, regarding antidepressant treatments of major depression over the past three decades.
Study design and setting
We conducted network meta-analyses (NMAs)...
Background
There are many different skill components used in cognitive behavioural therapy (CBT). However, there is currently no comprehensive way of measuring these skills in patients.
Objective
To develop a comprehensive and brief measure of five main CBT skills: self-monitoring, behavioural activation, cognitive restructuring, assertiveness tra...
Introduction:
Drug misuse is associated with significant global morbidity, mortality, economic costs and social costs. Many primary care facilities have integrated drug misuse screening and brief intervention (BI) into their usual care delivery. However, the efficacy of BI for drug misuse in primary care has not been substantiated through meta-ana...
Background
Racial/ethnic disparities exist at many levels of substance use disorder (SUD) treatment and recovery, reflecting biological and socioeconomic factors. However, racial/ethnic disparities in SUD treatment effectiveness have not been sufficiently investigated.
Methods
Data for US outpatient SUD treatment facilities receiving public fundin...
Incarceration may be an overlooked reason for treatment non-completion experienced disproportionately by African Americans. This study utilized multilevel logistic regression to model treatment non-completion due to incarceration using the 2015–2016 Treatment Episode Dataset–Discharges. Among a sample restricted to treatment non-completers (n = 306...
Recovery from addiction requires various personal and environmental resources. The purposes of this study were to determine if the Assessment of Recovery Capital (ARC) scores measured at admission could predict substance abuse treatment (SAT) completion and to identify personal and environmental factors associated with ARC scores. Participants (N=2...
Healthcare settings frequently rank among the lowest for referring clients to substance use disorder (SUD) treatment. Screening, Brief Intervention, and Referral to Treatment (SBIRT) was employed to improve SUD outcomes; yet, effectiveness evidence is still needed. We used secondary data from patients screened in federally qualified health centers...
Free full text until 12/7/19: --- https://authors.elsevier.com/a/1Zwoc1LiD2-ffG ---
Background: Recovery capital represents client strengths associated with substance use disorder (SUD) recovery. Employment is part of recovery capital supporting long-term recovery. However, employment recovery capital (ERC) factors associated with SUD recovery are...
Background
Substance use disorders (SUDs) pose a significant public health concern. Previous findings, while equivocal, demonstrate screening, brief intervention, and referral to treatment (SBIRT) is effective in reducing substance use and improving overall health. While race/ethnic and sex differences in SBIRT outcomes exist, racial/ethnic differe...
Mental health professionals and administrators work to improve substance use treatment for racially and ethnically diverse populations. However, a national comparison study of Asian Americans and Pacific Islanders (AAPIs) and non-AAPIs substance use outpatient treatment completion has received little attention. The present study examined treatment...
The present special report sought to identify important characteristics to consider in the
treatment of Iowa veterans for substance use disorders. The analyses of Iowa veterans
addresses the following questions:
- How are Iowa veteran admission percentages changing over time?
- Who are Iowa veterans presenting in non-VA SUD treatment?
- What vetera...
A belief of educational meritocracy is prevalent in most industrialized societies. However, culturally specific forms of educational meritocracy have received little attention from counseling researchers. This study explores hakbeol, a South Korean social construct that emphasizes social rankings based on one’s educational success, and its impact o...
Background:
Recent changes in marijuana policies and their potential negative effects on youth development are a public health concern. Identifying the most appropriate treatment approaches for problematic marijuana use is important.
Objectives:
The aim of this study was to track marijuana use among young people by examining national changes fro...
Objective
The goal of this study was to determine whether the 50-item Assessment of Recovery Capital scale represents a single general measure or whether multiple domains might be psychometrically useful for research or clinical applications.
Methods
Data are from a cross-sectional de-identified existing program evaluation information data set wit...
There are several methods for building prediction models. The wealth of currently available modeling techniques usually forces the researcher to judge, a priori, what will likely be the best method. Super learning (SL) is a methodology that facilitates this decision by combining all identified prediction algorithms pertinent for a particular predic...
Objective
The purpose of the present study is to explore the stability of the Alcohol Use Disorders Identification Test (AUDIT) in a clinical setting by comparing prescreening heavy drinking questions and AUDIT scores over time. Because instrument stability is equal to test–retest reliability at worst, investigating the stability of the AUDIT would...
This study examines the association between exposure to microaggressions and marijuana use, using original survey data from a sample of racial/ethnic minority college students (n = 332) from a large Division I university in the United States. Nearly all of our sample (96%) reported at least one experience with microaggressions in the past 6 months,...
Background:
A national analysis of Asian Americans and Pacific Islanders (AAPI) substance use treatment admissions has yet to be studied. We sought to explore admission trends for AAPI, demographic and treatment variable change, and individual state admission change over time.
Methods:
We used retrospective time-series logistic regression treati...
Limited time open access:
http://authors.elsevier.com/a/1TQ1c_6zzLr3~q
Unhealthy drinking is a significant problem contributing to poor health and performance of military personnel. The Iowa Army National Guard and the Iowa Department of Public Health have collaborated with the Substance Abuse and Mental Health Administration to better identify u...
Current estimates suggest anywhere from 16% to 23% of American adults and 33% of adults under the
age of 30 identify as nonreligious. Many people experience spiritual struggles and may seek counseling
when deciding to leave the religion of their family of origin. The current state of nonreligiousness in
America suggests psychologists may see an inc...
The social class worldviews (social class beliefs, attitudes, and values) of 14 first-generation college students were investigated with qualitative interviews. Consensual qualitative research analysis revealed first-generation students’ perspectives on the development of their social class worldviews, the effect of these worldviews on their transi...
The present study explores characteristics of successful substance abuse treatment completion of pregnant women through an analysis of retrospective outcomes data. Women without prior treatment admissions, aged 18–44, and not in methadone maintenance therapy were included (N = 678,782). Chi-square tests analyzed significant differences; logistic re...
Increases in Hispanic youth admissions to substance abuse treatment programs for marijuana use are a growing public health concern. In this study, we investigated trends in Hispanic youth from 1995 to 2012 utilizing the Treatment Episode Data Set—Admissions of the Substance Abuse Mental Health Services Administration. Hispanic youth marijuana admis...
This study examines sources of referral for prescription opioid admission to substance use disorder treatment facilities and their relative completion success rates using secondary analysis of an existing data set (Treatment Episode Datasets – Discharge). Five years of data from public and private treatment facilities were extracted for client disc...
Objectives
To compare substance use treatment differences of individuals aged 65 and older with that of those younger than 65 by analyzing smaller age groupings. DesignA retrospective analysis using Kruskal-Wallis chi-square and chi-square tests of association. Covariates were entered into an adjusted logistic regression to predict successful treat...
Roman Catholic diocesan priests are a subgroup of men with unique religious and spiritual roles, beliefs, and practices. This qualitative study of 15 priests from the mid-Atlantic area of the United States focused on how priests' relationship with God and promises of celibacy and obedience influenced their psychological health. Using a consensual q...
Objective: To discover differences between student and non-student substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in non-intensive and ambulatory intensive outpatient treatment se...
Little is known about Catholic priests' mental health help-seeking. Using consensual qualitative research, this study examined 15 Catholic priests' narratives about help-seeking attitudes, help-seeking behaviours, and offers advice for mental health professionals regarding priest health. Analysis revealed that all 15 priests reported positive attit...
Men's health has been receiving increased attention in health care research and practice because of associated negative outcomes and men's reluctance to seek help. Religion or religiosity, defined as involvement in an organized, structured community focused on moral code, and spirituality, defined as the subjective, mystical, and holistic interpret...
Projects
Projects (5)
We want to rapidly and continuously provide summaries of a) the prevalence of mental health issues, including alcohol/substance abuse and violent/aggressive behaviour and b) change in mental health symptom severity in the general population in relation to the COVID-19 pandemic and the containment measures.
Our project combines ideas of crowdsourcing the research process with open and participatory science. Central to our success, is therefore the voluntary contribution of time and effort made by a crowd of over 100 researchers, working in 24 different countries. Without their valuable contributions, this project would not be possible.