Web-based treatment for substance use disorders: Differential effects by primary substance
Web-based treatment for substance use disorders: Differential effects by primary substance
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DOI：
10.1016/j.addbeh.2015.02.002
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发表时间：
2015-06-01
影响因子：
4.4
通讯作者：
Nunes, Edward V.
中科院分区：
文献类型：
--
作者：
Cochran, Gerald;Stitzer, Maxine;Nunes, Edward V.
简介：这是一项大型多中心有效性试验数据的二次分析，（NCT 01104805）试图确定基于网络的行为治疗的效果是否（治疗教育系统[TES]）的差异由参与者的自我确定的主要药物abuse.Methods：所有来访者样本的个人进入门诊心理社会咨询治疗的物质滥用（N = 497）引用大麻（22.9%; n = 114）、兴奋剂（34.4%，n = 171）、阿片类药物（21.7%，n = 108）或酒精（20.9%，n = 104）作为其主要滥用物质。参与者被随机分配接受常规治疗（TAU），有或没有TES替代约2小时的常规咨询。结果：调整后的优势比（AOR）显示，与接受TAU的兴奋剂使用者相比，接受TES的主要兴奋剂使用者在治疗的最后4周更有可能戒烟（AOR = 3.59，95%CI = 1.25-10.27）。酒精（AOR = 3.15，95%CI = 0.85-11.65）和大麻（AOR = 2.64，95%CI = 0.73-9.52）的校正比值比也与兴奋剂相似，但未达到显著性。TES干预并未改善主要阿片类药物使用者的禁欲（AOR = 035，95%CI =0.09-1.47）。这项研究支持TES网络提供的治疗作为一个可行的干预大多数物质使用者进入门诊咨询治疗，在兴奋剂使用者中证明有效，在酒精和大麻使用者中有希望，但在类阿片初级使用者中几乎没有效果。网络提供的治疗有望扩大对大多数物质使用障碍的有效行为干预的可用性。(C)2015爱思唯尔有限公司版权所有。
Introduction: This secondary analysis of data from a large, multi-site effectiveness trial (NCT01104805) sought to determine whether effects of a web-based behavioral treatment (Therapeutic Education System [TES]) differed by participants' self-identified primary drug of abuse.Methods: The all-comers sample of individuals entering outpatient psychosocial counseling treatment for substance abuse (N = 497) cited cannabis (22.9%; n = 114), stimulants (34.4%, n = 171), opioids (21.7%, n = 108), or alcohol (20.9%, n = 104) as their primary substance of abuse. Participants were randomly assigned to receive treatment-as-usual (TAU) with or without TES substituted for approximately 2 h of usual counseling. Multivariate analyses of abstinence outcomes examined interactions of treatment effects with primary substance.Results: Adjusted odds ratios (AORs) demonstrated that primary stimulant users receiving TES were more likely to be abstinent in the final four weeks of treatment compared to stimulant users receiving TAU (AOR = 3.59,95% CI = 1.25-10.27). Adjusted odds ratios for alcohol (AOR = 3.15, 95% CI = 0.85-11.65) and cannabis (AOR = 2.64, 95% CI = 0.73-9.52) also were of similar magnitude to stimulants but did not reach significance. Abstinence among primary opioid users was not improved by the TES intervention (AOR = 035,95% CI =0.09-1.47).Conclusions: This study supports the TES web-delivered treatment as a viable intervention for the majority of substance users entering outpatient counseling treatment, with demonstrated effectiveness among stimulant users and promising effects in alcohol and cannabis users but little or no effect in primary opioid users. Web-delivered treatments hold promise for expanding the availability of effective behavioral interventions for the majority of substance use disorders. (C) 2015 Elsevier Ltd. All rights reserved.