The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial.
The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial.
复制标题
促进治疗外注射吸毒者接受治疗和戒毒的治疗工作场所：一项随机对照试验。
DOI：
10.1016/j.ypmed.2014.02.021
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发表时间：
2014
影响因子：
5.1
通讯作者：
Silverman,Kenneth
中科院分区：
文献类型：
--
作者：
Holtyn,AugustF;Koffarnus,MikhailN;DeFulio,Anthony;Sigurdsson,SigurdurO;Strain,EricC;Schwartz,RobertP;Leoutsakos,Jeannie-MarieS;Silverman,Kenneth
目的确定基于就业的强化是否可以提高未接受治疗的注射吸毒者的美沙酮治疗参与度和戒毒率。方法本研究于 2008 年至 2012 年在马里兰州巴尔的摩的一个治疗工作场所进行。经过 4 周的入职培训后，参与者 (N = 98) 可以工作并赚取工资 26 周，并被随机分配到工作强化、美沙酮和工作强化以及禁欲、美沙酮和工作强化条件。工作强化参与者必须工作才能获得报酬。美沙酮和工作强化以及戒断、美沙酮和工作强化参与者必须参加美沙酮治疗才能工作并最大限度地提高工资。戒酒、美沙酮和工作强化参与者必须提供鸦片和可卡因阴性的尿液样本才能最大限度地提高报酬。结果大多数参与者 (92%) 在入职期间参加了美沙酮治疗。戒毒率随着添加美沙酮和戒毒意外事件的分级函数而增加。与工作强化参与者相比，禁欲、美沙酮和工作强化参与者提供的阿片类药物（75% 对比 54%）和可卡因（57% 对比 32%）阴性的尿液样本明显更多。美沙酮和工作强化参与者提供的可卡因阴性样本明显多于工作强化参与者（55% 对 32%）。结论治疗工作场所可以促进治疗外注射吸毒者的戒毒。临床试验注册号：NCT01416584。
ObjectiveDetermine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users.MethodThis study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N = 98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay.ResultsMost participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%).ConclusionThe therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users.Clinical Trial Registration Number: NCT01416584.