Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance users
Open accessAbstract
Aims Post‐discharge monitoring and early reintervention have become standard practice when managing numerous chronic conditions. These two experiments tested the effectiveness of recovery management checkup (RMC) protocols for adult chronic substance users. Intervention RMC included quarterly monitoring; motivational interviewing to provide personalized feedback and to resolve ambivalence about substance use; treatment linkage, engagement and retention protocols to increase the amount of treatment received. Participants and setting Recruited from sequential addiction treatment admissions, participants in the two experiments were, on average, 36 and 38 years of age, mainly female (59% versus 46%), African American (85% versus 80%) and met past‐year criteria for dependence (87% versus 76%). Design Participants in both experiments were assigned randomly to the RMC or control condition and interviewed quarterly for 2 years. Measurement The Global Appraisal of Individual Needs (GAIN) was the main assessment instrument. Findings RMC participant outcomes were better than control participants in both experiments. Effect sizes were larger in the second experiment in terms of reducing days to readmission (Cohen's d = 0.41 versus d = 0.22), successive quarters in the community using substances (d = −0.32 versus −0.19), past‐month symptoms of abuse/dependence (d = −0.23 versus −0.02) and increasing the days of abstinence over 2 years (d = +0.29 versus 0.04). Conclusion RMC, which provided ongoing monitoring and linkage, is feasible to conduct and is effective for adults with chronic substance dependence.
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More intensive linkage programs have not been tested with SBIRT.
“Importantly, SBIRT has not been tested with more intensive linkage programs (79), which may be more effective with more severe patients.”
More intensive linkage programs may be more effective for patients with more severe conditions.
“Importantly, SBIRT has not been tested with more intensive linkage programs (79), which may be more effective with more severe patients.”
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“…a variety of domains including physical activity (King et al. (2013); Consolvo et al. (2008)), eating disorders (Bauer et al. (2010)), drug abuse (Scott and Dennis (2009)), alcohol use (Witkiewitz et al. (2014); Suffoletto et al. (2012); Gustafson et al. (2011)), smoking cessation (Riley et al.…”
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“Three RCTs of the RMC intervention have found modest, but reliable benefit compared to usual care/assessment-only across a range of recovery outcomes [209, 210].”
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“Continuing care interventions with longer durations and active efforts to deliver the intervention tend to show larger effects (McKay, 2009b; McKay et al., 2010; Scott & Dennis, 2009).”
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“…health theory that longterm monitoring through regular checkups and early (re)intervention will facilitate early detection of relapse, reduce the time to treatment re-entry, and, consequently, improve long-term outcomes (Scott & Dennis, 2009, 2010; Scott, Dennis, Laudet, Funk, & Simeone, 2011).”
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Self-citationA randomized clinical trial of smartphone self-managed recovery support services
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“Based on a public health model of monitoring and early reintervention, RMC was developed and tested to reduce the time from relapse to treatment reentry and prolong recovery (e.g., Dennis et al. 2003a; Dennis and Scott 2012; Scott et al. 2005, 2011; Scott and Dennis 2009).”
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“…in SUD treatment and received quarterly follow-ups for 2 to 4 years (Dennis, Scott, & Funk, 2001; Dennis & Scott, 2012; Scott, Dennis & Foss, 2005; Scott & Dennis, 2009), and one randomized trial in which individuals were recruited at discharge from jail-based SUD treatment and received quarterly…”
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Kaminer, Y., & Godley, M. (2010) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2010.03.009 · Cited by 27 · see citing works
Who benefits from extended continuing care for cocaine dependence?
McKay, J. R., Van Horn, D. H. A., Lynch, K. G., Ivey, M., Cary, M. S., Drapkin, M., & Coviello, D. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.11.019 · Cited by 26 · see citing works
McCollister, K., French, M., Freitas, D. M., Dennis, M. L., Scott, C. K., & Funk, R. R. (2013) · Addiction · doi:10.1111/add.12335 · Cited by 26 · see citing works
Self-citationInitiation and Engagement in Chronic Disease Management Care for Substance Dependence
Kim, T. W., Saitz, R., Cheng, D., Winter, M., Witas, J., & Samet, J. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2010.10.013 · Cited by 26 · see citing works
Rush, B. R., & Urbanoski, K. A. (2019) · Journal of Studies on Alcohol and Drugs Supplement · doi:10.15288/jsads.2019.s18.9 · Cited by 28 · see citing works
“…have been developed that conceptualize treatment follow-up as an extension of the treatment and support process itself (Dennis et al., 2003; Scott & Dennis, 2009), as well as approaches that focus on within-treatment assessment of outcomes offering immediate feedback to both clinicians and…”
BackgroundHawkins, E., Malte, C., Baer, J., & Kivlahan, D. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2011.11.002 · Cited by 25 · see citing works
“…addiction is a chronic condition (McLellan, 2002; McLellan, Lewis, O'Brien, & Kleber, 2000) characterized by multiple episodes of treatment (Scott & Dennis, 2009; Scott, Dennis, & Foss, 2005; Substance Abuse and Mental Health Services Administration, 2009) and cycles of cessation and…”
BackgroundSynergy between Seeking Safety and Twelve-Step Affiliation on Substance Use Outcomes for Women
Morgan-Lopez, A., Saavedra, L., Hien, D., Campbell, A. N. C., Wu, E., & Ruglass, L. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.01.015 · Cited by 24 · see citing works
“The impact of factors that are unrelated to a focal treatment protocol can grow exponentially, even as patients are far-removed from the formalized treatment context (McLellan, Chalk, & Bartlett, 2007; McLellan, McKay, Forman, Cacciola, & Kemp, 2005; Scott & Dennis, 2009).”
BackgroundInfluentialScott, C. K., Grella, C., Dennis, M. L., & Nicholson, L. (2017) · Journal of Behavioral Health Services & Research · doi:10.1007/s11414-017-9576-5 · Cited by 23 · see citing works
Self-citationCharacteristics and Nine Month Outcomes of Discharged Methadone Maintenance Clients
Coviello, D. M., Zanis, D., Wesnoski, S. A., Lynch, K., & Drapkin, M. L. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2010.09.007 · Cited by 23 · see citing works
“Due to the chronic nature of addition, there is a need for interventions like recovery management check-ups (Dennis et al., 2003; Scott & Dennis, 2009) that involve monitoring substance abusers over expended periods.”
Profile of Addicted Patients who Reenter Treatment Programs
López-Goñi, J. J., Fernández-Montalvo, J., Cacho, R., & Arteaga, A. (2014) · Substance Abuse · doi:10.1080/08897077.2013.826614 · Cited by 20
Efficacy of extensive intervention models for substance use disorders: A systematic review
Simoneau, H., Kamgang, E., Tremblay, J., Bertrand, K., Brochu, S., & Fleury, M. (2018) · Drug and Alcohol Review · doi:10.1111/dar.12590 · Cited by 19 · see citing works
Brief interventions for alcohol misuse
Moyer, A. E., & Finney, J. W. (2015) · Canadian Medical Association Journal · doi:10.1503/cmaj.140254 · Cited by 40 · see citing works
Recovery Management and the Future of Addiction Treatment and Recovery in the USA
Kelly, J., & White, W. (2010) · Humana Press eBooks · doi:10.1007/978-1-60327-960-4_16 · Cited by 18 · see citing works
Beldena, C., Kopaka, A., Coulesa, C., Friesena, T., Hallb, J., & Shuklaa, S. (2024) · Journal of substance use and addiction treatment · doi:10.1016/j.josat.2024.209364 · Cited by 17
Yegorov, S., Bromage, S., Boldbaatar, N., & Ganmaa, D. (2019) · Frontiers in Nutrition · doi:10.3389/fnut.2019.00166 · Cited by 20 · see citing works
“The screening and recruitment of participants was described previously (9, 12).”
BackgroundBrunelle, N., Bertrand, K., Landry, M., Flores-Aranda, J., Patenaude, C., & Brochu, S. (2015) · Drugs Education Prevention and Policy · doi:10.3109/09687637.2015.1021665 · Cited by 16 · see citing works
“This result raises issues concerning the chronic nature of substance misuse among many drug-dependent people (Hser et al., 2007; Scott & Dennis, 2009).”
BackgroundThe Evolution of a UK Evidence Base for Substance Misuse Recovery
Groshkova, T., & Best, D. (2011) · Journal of Groups in Addiction & Recovery · doi:10.1080/1556035x.2011.571135 · Cited by 16 · see citing works
“Scott and Dennis (2009) operationalized recovery management check-ups as quarterly check-ups that are supplemented by motivational interviewing and treatment linkage and that provide ongoing support.”
BackgroundTreating Cannabis Use Disorder: Exploring a Treatment As Needed Model with 34-Month Follow-Up
Stephens, R., Walker, R., DeMarce, J., Lozano, B., Rowland, J., Walker, D., & Roffman, R. (2020) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2020.108088 · Cited by 15 · see citing works
“Dennis and colleagues (Dennis et al., 2003; Scott & Dennis, 2009) have used recovery management checkups to motivate chronic substance abusers to reengage with treatment based on follow-up assessments.”
BackgroundAdvancing Analytic Approaches to Address Key Questions in Mechanisms of Behavior Change Research.
Hallgren, K. A., Wilson, A. D., & Witkiewitz, K. (2018) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2018.79.182 · Cited by 15 · see citing works
“…to develop, test, and implement electronic health record tools that are informed by MOBC research to support the collection and tracking of behavioral health data to aid clinical decision making (Hallgren et al., 2017) and promote long-term recovery outcome monitoring (Scott & Dennis, 2009).”
MethodKenaszchuk, C., Wild, T., Rush, B., & Urbanoski, K. (2013) · Addictive Behaviours · doi:10.1016/j.addbeh.2013.02.013 · Cited by 14
McKay, J. R., Van Horn, D., Ivey, M., Drapkin, M. L., Rennert, L., & Lynch, K. G. (2013) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2013.74.642 · Cited by 13 · see citing works
“Moreover, continuing care interventions with longer durations and active efforts to deliver the intervention tend to show larger effects (Dennis and Scott, 2012; McKay, 2009a; Scott and Dennis, 2009).”
BackgroundSvendsen, T. S., Bjørnestad, J., Slyngstad, T. E., McKay, J., Skaalevik, A. W., Veseth, M., Moltu, C., & Nesvaag, S. (2020) · Substance Abuse Treatment, Prevention, and Policy · doi:10.1186/s13011-020-0254-x · Cited by 13 · see citing works
“[13] and similar ones [11, 14] clearly show that there does not exist a”
BackgroundPatients’ Perspectives on Care Management Services for Complex Substance Use Disorders
Hawkins, E., Lott, A. M. K., Malte, C., Frank, A., Hamilton, B. L., Sayre, G. G., Painter, J. M., & Baer, J. (2017) · Journal of Addictive Diseases · doi:10.1080/10550887.2017.1326654 · Cited by 12 · see citing works
McKay, J., Knepper, C., Deneke, E., O'Reilly, C., & Dupont, R. (2016) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2016.04.003 · Cited by 12 · see citing works
Shepard, D., Daley, M., Neuman, M. J., Blaakman, A., & McKay, J. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.11.034 · Cited by 12 · see citing works
“…t ECONOMIC ANALYSIS OF CONTINUING CARE ALTERNATIVES 15 TEL is an example of a technological advance that has t e potential to expand access to AOD treatment to formerly underserved populations (Strecher, 2007; Bewick et al., 2008; Riper et al., 2007; Scott and Dennis, 2009; Stead et al., 2007).”
BackgroundRuetsch, C. R., Cacciola, J., & Tkacz, J. P. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2010.07.003 · Cited by 13 · see citing works
Song, Y.-M., Li, X., Li, C., Xu, S., Liu, Y., & Wu, X.-M. (2022) · International Journal of Public Health · doi:10.3389/ijph.2022.1604989 · Cited by 11 · see citing works
“Boulay, MÈ [23] 2017 Canada Populationbase non-smokers 20 Placebo (no e-liquid) N/A 1 hour 60 min N/A N/A N/A N/A”
Davis, J. P., Rao, P., Dilkina, B., Prindle, J. J., Eddie, D., Christie, N. C., DiGuiseppi, G. T., Saba, S. K., Ring, C., & Dennis, M. L. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109359 · Cited by 11 · see citing works
Self-citationScott, C. K., Dennis, M. L., & Gustafson, D. H. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.04.003 · Cited by 11 · see citing works
Self-citationScott, C. K., Dennis, M. L., Grella, C. E., Watson, D. P., Davis, J. P., & Hart, M. K. (2022) · Addiction · doi:10.1111/add.16064 · Cited by 13 · see citing works
“The validity of self-report was strengthened by conducting urine tests on site with CLIA-waived QuikScreen cups using an immunochromatographic assay for rapid qualitative results (2–5 minutes), providing the results before the self-report questions, and probing any inconsistencies per our prior protocol [33].”
Self-citationYu, J., & Warner, L. (2013) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2012.694517 · Cited by 10
“Together, the descriptive and predictive results may be used to inform the extent to which recovery management protocols (16) should be tailored for Asian cultural and linguistic subgroups.”
BackgroundBillingham, D., Kelly, P., Deane, F., Crowe, T., Buckingham, M., & Craig, F. L. (2012) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-012-9384-3 · Cited by 10 · see citing works
Godley, M., Passetti, L., Hunter, B. D., Greene, A., & White, W. (2018) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2018.11.014 · Cited by 9 · see citing works
Hilton, T., & Pilkonis, P. A. (2015) · Behavioral Sciences · doi:10.3390/bs5040477 · Cited by 13 · see citing works
Using Mobile Phone Technology to Provide Recovery Support for Women Offenders
Scott, C. K., Johnson, K. A., & Dennis, M. L. (2013) · Telemedicine journal and e-health · doi:10.1089/tmj.2012.0309 · Cited by 9
Self-citationDennis, M. L., French, M., McCollister, K., & Scott, C. K. (2011) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2011.02.007 · Cited by 9 · see citing works
Self-citationMcKay, J. (2010) · Humana Press eBooks · doi:10.1007/978-1-60327-960-4_10 · Cited by 9 · see citing works
“The work of Dennis, Scott, and colleagues [35, 36 ] addresses some of the limitations noted here in the continuing care literature.”
BackgroundMethodResultInfluentialRush, B., Martin, G., Corea, L., & Rotondi, N. (2012) · Substance Use & Misuse · doi:10.3109/10826084.2012.696299 · Cited by 8
“The model is based largely on the Recovery Management Check-up (RMC) approach (Dennis, Scott, & Funk, 2003; Rush, Dennis, Scott, Castel, & Funk, 2008; Scott & Dennis, 2009; Scott, Dennis, & Foss, 2005) developed to monitor and manage the chronicity of substance dependence.”
MethodScott, C. K., Dennis, M. L., Grella, C. E., Watson, D. P., Davis, J. P., & Hart, M. K. (2023) · Alcohol, clinical & experimental research · doi:10.1111/acer.15172 · Cited by 7 · see citing works
Self-citationWorthington, N., Gilliam, T., Mital, S., & Caslin, S. (2022) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000001611 · Cited by 7 · see citing works
Addiction Severity Index Profile of Persons who Reenter Treatment for Substance use Disorders
Simoneau, H., & Brochu, S. (2017) · Substance Abuse · doi:10.1080/08897077.2017.1356786 · Cited by 7 · see citing works
McCollister, K., Scott, C. K., Dennis, M. L., Freitas, D. M., French, M., & Funk, R. R. (2014) · Journal of Offender Rehabilitation · doi:10.1080/10509674.2014.944739 · Cited by 7 · see citing works
“OM is based on a highly structured follow-up model for successfully completing outcome assessments with more than 90% of participants in drug outcome studies (Scott, 2004; Scott & Dennis, 2009; Scott, Sonis, Creamer, & Dennis, 2006).”
BackgroundMethodSelf-citationMcKay, J., & Carise, D. (2009) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2008.10.007 · Cited by 7
On the need and contents of a specific addiction recovery research agenda
White, W. L., & Kelly, J. F. (2026) · Addiction · doi:10.1111/add.70347 · Cited by 6 · see citing works
“…assessment protocol, partnership-rather than expert-based service relationships, evidence-based and integrated treatment methods, assertive linkage to indigenous recovery resources, prolonged post-treatment monitoring and support [71], and, if and when needed, early reintervention [71, 72].”
Johnson, K. A., Hunt, T., Puglisi, L., Maeng, D., Epa-Llop, A., Elumn, J. E., Nguyen, A., Leung, A., Chen, R., Shah, Z., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.867445 · Cited by 6 · see citing works
“The reliable and well-validated GAIN Internal Mental Distress Scale (IMDS) component assesses depression and anxiety symptoms over the preceding 90 days and year (severe, none or moderate) (56).”
MethodComputerized Recovery Support for Substance Use Disorders: Predictors of Posttreatment Usage
Klein, A. A. (2014) · Telemedicine journal and e-health · doi:10.1089/tmj.2013.0252 · Cited by 6 · see citing works
Motivational Interviewing Approach
Anstiss, T., & Passmore, J. (2012) · Wiley eBooks · doi:10.1002/9781118326459.ch18 · Cited by 8 · see citing works
Delucchi, K., Kline-Simon, A., & Weisner, C. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.12.006 · Cited by 5 · see citing works
“Another important example associated with better outcomes is Recovery Management Check-ups which involve quarterly management checkups after treatment (Dennis et al., 2003; Scott and Dennis, 2009).”
BackgroundEvidence-Based Substance Abuse Treatment for Adolescents: Engagement and Outcomes
Ruiz, B. S., Korchmaros, J. D., Greene, A., & Hedges, K. (2011) · doi:10.1080/09503153.2011.597207 · Cited by 5
“As mentioned, study after study has demonstrated that if individuals engage in treatment positive outcomes are achieved (Austin and Wagner 2010; Scott and Dennis 2009; Simmons et al. 2008; Stevens, Schwebel, and Ruiz 2007; White and McLellan 2008).”
BackgroundHIV/STI/HCV Risk Clusters and Hierarchies Experienced by Women Recently Released from Incarceration
Johnson, K. A., Hunt, T., Puglisi, L., Chapman, B., Epa-Llop, A., Elumn, J. E., Braick, P., Bhagat, N., Ko, E., Nguyen, A., et al. (2023) · Healthcare · doi:10.3390/healthcare11081066 · Cited by 4
“Divisible into shorter sub-scales, the GAIN Internal Mental Distress Scale (IMDS) is reliable and well validated, thus, was used to assess depression and anxiety symptoms (categorized as severe, none, or moderate) over the previous 90 days and the previous year [40].”
BackgroundMethodMillet-based supplement restored microbiota diversity of acute undernourished pigsPreprint
Li, X., Hui, Y., Ren, J., Song, Y., Liu, S., Che, L., Peng, X., & Dai, X. (2019) · bioRxiv · doi:10.1101/2019.12.13.875013 · Cited by 4 · see citing works
“have shown that 63 dietary intervention can promote good absorption of nutrients and prevent or improve 64 malnutrition [19,20,21].”
BackgroundKelly, P. J., Deane, F. P., Baker, A. L., Townsend, C., McKay, J., Degan, T. J., Nolan, E. K., Palazzi, K., Byrne, G., Osborne, B., et al. (2025) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2025.112668 · Cited by 3 · see citing works
Joseph, D., Brokowski, C., D’Onofrio, G., Bogucki, S., McGovern, J., Allen, R., Dziura, J., Cone, D. C., & Pantalon, M. (2024) · Substance use & addiction journal · doi:10.1177/29767342241266412 · Cited by 3 · see citing works
“…treatment; OUD, opioid use disorder collaborative effort to synthesize 3 critical areas of knowledge and skill: evidence-based approaches to OUD, as described above; professional recovery coaching (in this case offered by people with lived experience), as described by Scott and Dennis 52 ; and EMS.”
Watson, D. P., Singh, R. R., Taylor, L., Dennis, M. L., Grella, C. E., Johnstone, C., Browne, K., & Saldana, L. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1443409 · Cited by 2 · see citing works
Self-citation
- Authors
- Scott, C. K., & Dennis, M. L.
- Affiliations
- Chestnut Health Systems (US)
- Corresponding author
- Scott, Christy K
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2009-05-06
- Volume
- 104
- Issue
- 6
- Pages
- 959-971
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC2695999
- OpenAlex
- W2009249897
- Cited by
- 123
- References
- 35
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 5 · 2019: 6 · 2018: 6 · 2017: 14 · 2016: 4 · 2015: 8 · 2014: 6 · 2013: 12 · 2012: 11
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R37DA011323, DA11323, R01DA011323)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- chronic substance use, substance dependence, post-discharge monitoring, motivational interviewing, linkage to treatment, treatment engagement and retention, relapse prevention, abstinence, addiction treatment
- MeSH terms
- Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Time Factors, Program Evaluation, Outcome Assessment, Health Care, Substance-Related Disorders, Young Adult
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