The effectiveness of two intensities of psychosocial treatment for cocaine dependence
The effectiveness of two intensities of psychosocial treatment for cocaine dependence
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DOI：
10.1016/s0376-8716(00)00136-8
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发表时间：
2001-01-01
影响因子：
4.2
通讯作者：
Zanis, DA
中科院分区：
文献类型：
--
作者：
Coviello, DM;Alterman, AI;Zanis, DA
尽管流失率很高，但结构化治疗可卡因依赖已被证明是有效的。目前尚不清楚需要什么水平的治疗强度来改善和维持患者的结果，特别是在低SES城市居民中。这项研究评估了两种水平的可卡因依赖治疗强度在减少物质使用、改善健康和社会指标方面是否存在差异。94名依赖可卡因的退伍军人(主要是非洲裔美国男性)被随机分配到每周12小时的日间医院计划(DH12)或每周6小时的门诊计划(OP6)，并在基线、治疗期间以及治疗后4个月和7个月进行评估。两种治疗强调戒断、行为改变和亲社会适应，只是治疗强度不同。治疗期间采取的措施包括尿毒作用、参加计划、完成治疗和善后护理。参与者报告说，可卡因的使用天数减少了52%，在治疗后的七个月里，就业和精神功能都有了显著的改善。然而，在4个月和7个月时，DH12和OP6计划在治疗期间、治疗完成、治疗或善后护理期间的戒断情况或任何与成瘾严重程度指数(ASI)相关的变量评估水平方面没有显著差异。虽然未来有必要对包括女性客户在内的更大规模的社区样本进行研究，但目前的研究结果表明，每周6小时的方案同样有效，因此与每周12小时的可卡因依赖治疗方式相比，有显著的成本节约。(C)2001爱思唯尔爱尔兰科学有限公司。保留所有权利。
Structured treatments for cocaine dependence have been shown to be effective despite high attrition rates. What is unclear is what level of treatment intensity is needed to improve and sustain patient outcomes, especially among low SES urban residents. This study evaluated whether there were differences between two levels of treatment intensities for cocaine dependence in reducing substance use and improving health and social indicators. Ninety-four cocaine dependent predominantly African-American male veterans were randomly assigned to either a 12 h/week day hospital program (DH12) or a 6 h/week outpatient program (OP6) and were evaluated at baseline, during treatment and at 4 and 7 months post-treatment. Both treatments stressed abstinence, behavior change and prosocial adjustment and only differed in level of treatment intensity. During treatment measures included urine toxicologies, program attendance, treatment completion and aftercare attendance. Participants reported a 52% reduction in days of cocaine use and experienced significant improvements in employment and psychiatric functioning at seven months post-treatment. However, there was no significant difference between the DH12 and OP6 programs in terms of abstinence during treatment, treatment completion, treatment or aftercare attendance or any Addiction Severity Index (ASI)-related variable assessing level of functioning at 4 and 7 months. While future research with a larger community-based sample that includes female clients is necessary, the current findings demonstrate that a 6 h/week program is just as effective and thus has a significant cost savings compared to a 12 h/week treatment modality for cocaine dependence. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.