Reinforcement-based therapy: 12-month evaluation of an outpatient drug-free treatment for heroin abusers
Reinforcement-based therapy: 12-month evaluation of an outpatient drug-free treatment for heroin abusers
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DOI：
10.1016/j.drugalcdep.2005.01.006
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发表时间：
2005-08-01
影响因子：
4.2
通讯作者：
Stitzer, ML
中科院分区：
文献类型：
--
作者：
Jones, HE;Wong, CJ;Stitzer, ML
这项对照研究检查了基于戒断的治疗（RBT）在阿片类药物依赖患者退出短暂住院戒毒12个月内产生增强戒断结果的疗效。患者在完成医学管理的逐渐减量后被随机分配（即，戒毒）RBT（N= 66）或常规护理（N= 64）转介到社区治疗方案。为期6个月的RBT方案提供了一系列基于禁欲的激励措施，包括支付康复住房的租金、方案主导的娱乐活动和获得就业的技能培训。在治疗期间的1个月（42%对15%）和3个月（38%对17%），RBT产生了显着更高的自我报告和尿液分析证实的阿片类药物和可卡因戒断率，但在入组后6个月或12个月时则没有。在3.6个月和12个月时，RBT组的工作天数和法律的收入显著增加，而普通护理组则没有。这项随机研究的结果表明，一个强化的基于戒烟的治疗，包括基于禁欲的恢复住房是一个有前途的方法;然而，需要进一步的研究，以确定治疗强度的作用和RBT的组成部分的具体疗效。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
This controlled study examined the efficacy of reinforcement-based therapy (RBT) for producing enhanced abstinence outcomes over 12 months in opioid-dependent patients exiting a brief residential detoxification. Patients were randomly assigned upon completing their medically managed taper (i.e., detoxification) to RBT (N= 66) or usual care (N= 64) referral to community treatment programs. The 6-month RBT program offered an array of abstinence-based incentives including rent payment for recovery housing, program-led recreational activities and skills training for procuring employment. RBT produced significantly higher self-report and urinalysis-confirmed rates of abstinence from opioids and cocaine relative to usual care at 1 (42% versus 15%) and 3 (38% versus 17%) months during treatment but not at 6 or 12 months after enrollment. The RBT but not the usual care group showed significant increases in the number of days worked and the amount of legal income earned at 3.6 and 12 months. The results of this randomized study suggest that an intensive reinforcement-based therapy that includes abstinence-based recovery housing is a promising approach; however, further research is needed to determine the role of treatment intensity and the specific efficacy of RBT's component parts. (c) 2005 Elsevier Ireland Ltd. All rights reserved.