The Effects of Psychosocial Services in Substance Abuse Treatment
The Effects of Psychosocial Services in Substance Abuse Treatment
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心理社会服务在药物滥用治疗中的作用
DOI：
10.3109/10884609309149701
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发表时间：
1993
影响因子：
1.5
通讯作者：
Charles P. O'Brlen
中科院分区：
文献类型：
--
作者：
T. McLellan;I. Arndt;D. Metzger;G. Woody;Charles P. O'Brlen
目标。研究咨询、医疗和心理社会服务的增加是否提高了盐酸美沙酮治疗阿片依赖患者康复的疗效。设计。随机分配到三个治疗组中的一个进行为期6个月的临床试验：(1)最低美沙酮服务(MMS)--仅美沙酮(至少60毫克/天)，不提供其他服务；(2)标准美沙酮服务(SMS)--相同剂量的美沙酮加咨询；或(3)强化美沙酮服务(EMS)--相同剂量的美沙酮加咨询以及现场医疗/精神科、就业和家庭治疗。设置。费城(宾夕法尼亚州)退伍军人事务医疗中心的美沙酮维持计划。受试者。92例男性静脉注射阿片类药物患者美沙酮维持治疗。结果。虽然美沙酮单独治疗(MMS)与阿片类药物使用的减少有关，但由于不断使用阿片类药物或可卡因，或医疗/精神紧急情况，这些受试者中69%的人不得不以保护性方式从试验中转移。这与符合标准的41%的短信受试者和19%的EMS受试者有显著不同。治疗结束时(24周)的数据显示，在完成试验的10名MMS患者中，改善幅度很小。与MMS组相比，SMS组显示出明显更多和更大的改善；EMS组显示出明显好于SMS组的结果。被“保护性转移”到标准护理的美沙酮最低服务受试者在4周内鸦片和可卡因的使用量显著减少。结论。仅美沙酮(即使是大剂量的美沙酮)可能只对少数符合条件的患者有效。基本咨询的增加与疗效的显著提高有关；而现场专业服务的增加甚至更有效。
Objective. To examine whether the addition of counseling, medical care, and psychosocial services improves the efficacy of methadone hydrochloride therapy in the rehabilitation of opiate‐dependent patients. Design. Random assignment to one of three treatment groups for a 6‐month clinical trial: (1) minimum methadone services (MMS)—methadone alone (a minimum of 60 mg/d) with no other services; (2) standard methadone services (SMS)—same dose of methadone plus counseling; or (3) enhanced methadone services (EMS)—same dose of methadone plus counseling and on‐site medical/psychiatric, employment, and family therapy. Setting. The methadone maintenance program of the Philadelphia (Pa) Veterans Affairs Medical Center. Subjects. Ninety‐two male intravenous opiate users in methadone maintenance treatment. Results. While methadone treatment alone (MMS) was associated with reductions in opiate use, 69% of these subjects had to be “protectively transferred” from the trial because of unremitting use of opiates or cocaine, or medical/psychiatric emergencies. This was significantly different from the 41% of SMS subjects and 19% of EMS subjects who met the criteria. End‐of‐treatment data (at 24 weeks) showed minimal improvements among the 10 MMS patients who completed the trial. The SMS group showed significantly more and larger improvements than did the MMS group; and the EMS group showed significantly better outcomes than did the SMS group. Minimum methadone services subjects who had been “protectively transferred” to standard care showed significant reductions in opiate and cocaine use within 4 weeks. Conclusions. Methadone alone (even in substantial doses) may only be effective for a minority of eligible patients. The addition of basic counseling was associated with major increases in efficacy; and the addition of on‐site professional services was even more effective.
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阿片类药物成瘾者的心理治疗。
影响因子：
--
作者：
Woody,GE;Luborsky,L;McLellan,AT;O'Brien,CP;Beck,AT;Blaine,J;Herman,I;Hole,A
通讯作者：
Hole,A
美沙酮维持服务需求未得到满足。
DOI：
10.3109/10826089109056235
发表时间：
1991
期刊：
The International journal of the addictions
影响因子：
--
作者：
Joe,GW;Simpson,DD;Hubbard,RL
通讯作者：
Hubbard,RL
美沙酮剂量意外事件对滥用多种药物的美沙酮维持患者尿液分析结果的影响。
影响因子：
4.2
作者：
Stitzer,ML;Bickel,WK;Bigelow,GE;Liebson,IA
通讯作者：
Liebson,IA
精神症状的严重程度作为心理治疗获益的预测指标：退伍军人管理局-宾夕法尼亚大学研究。
DOI：
10.1176/ajp.141.10.1172
发表时间：
1984
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Woody,GE;McLellan,AT;Luborsky,L;O'Brien,CP;Blaine,J;Fox,S;Herman,I;Beck,AT
通讯作者：
Beck,AT