Comparable Efficacy of Contingency Management for Cocaine Dependence Among African American, Hispanic, and White Methadone Maintenance Clients
Comparable Efficacy of Contingency Management for Cocaine Dependence Among African American, Hispanic, and White Methadone Maintenance Clients
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DOI：
10.1037/a0014575
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发表时间：
2009-03-01
影响因子：
3.4
通讯作者：
Petry, Nancy A.
中科院分区：
文献类型：
--
作者：
Barry, Danielle;Sullivan, Brendan;Petry, Nancy A.
可卡因的使用是美沙酮维护客户中的一个重大问题。应急管理(CM)是一种以强化为基础的方法，已证明对减少可卡因使用有效。这项研究考察了CM治疗对接受美沙酮阿片依赖维持治疗的可卡因依赖者的疗效是否因种族而不同。参与者是191名依赖可卡因的美沙酮维持治疗的非裔美国人、西班牙裔和白人，他们被随机分配到标准美沙酮治疗或标准美沙酮治疗加CM治疗12周。西班牙裔参与者比非裔美国人和白人参与者更年轻，受教育程度较低，报告的可卡因使用年限比非裔美国人和白人参与者少，报告的海洛因使用年限也比非裔美国人参与者少。与西班牙裔和白人参与者相比，非裔美国人参与者报告精神症状或治疗史的可能性较小。虽然CM与持续戒除可卡因的持续时间较长以及提交的尿样中可卡因呈阴性的比例较大有关，但种族与治疗结果无关，治疗与种族之间也没有显著的相互作用。CM似乎是治疗美沙酮维持服务客户中可卡因依赖的有效方法，无论其种族如何。
Cocaine use is a significant problem among methadone maintenance clients. Contingency management (CM) is a reinforcement-based approach with demonstrated efficacy for reducing cocaine use. This study examines whether the efficacy of CM treatment for cocaine-dependent individuals receiving methadone maintenance for opioid dependence differs by ethnicity. Participants were 191 African American, Hispanic, and White cocaine-dependent methadone maintenance clients, randomly assigned to standard methadone treatment or standard methadone treatment plus CM for 12 weeks. Hispanic participants were younger, less educated, and reported fewer years of cocaine use than did African American and White participants and reported fewer years of heroin use than did African American participants. African American participants were less likely to report a history of psychiatric symptoms or treatment in comparison with Hispanic and White participants. While CM was associated with longer duration of continuous cocaine abstinence and a greater proportion of submitted urine samples negative for cocaine, ethnicity was not related to treatment outcomes, and there was no significant interaction between treatment and ethnicity. CM appears to be an efficacious treatment for cocaine dependence among methadone maintenance clients, regardless of ethnicity.