Treatment of cocaine and alcohol dependence with psychotherapy and disulfiram
Treatment of cocaine and alcohol dependence with psychotherapy and disulfiram
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DOI：
10.1046/j.1360-0443.1998.9357137.x
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发表时间：
1998-05-01
期刊：
影响因子：
6
通讯作者：
Rounsavile, BJ
中科院分区：
文献类型：
--
作者：
Carroll, KM;Nich, C;Rounsavile, BJ
目标。评价双硫仑和三种形式的手动指导心理治疗对可卡因依赖和并发酒精滥用或依赖的个体的作用。设计随机对照试验。设置.城市药物滥用治疗中心。参与者122名可卡因/酒精滥用者（27%为女性; 61%为非洲裔美国人或西班牙裔）。干预。在12周内提供的五种治疗之一：认知行为治疗（CBT）+双硫仑;十二步促进（TSF）+双硫仑;临床管理（CM）+双硫仑; CBT+无药物; TSF+无药物。测量.持续戒除可卡因或酒精的持续时间;每周可卡因和酒精的频率和数量，通过尿液毒理学和呼吸测醉器筛选进行验证。调查结果。双硫仑治疗与显著更好的治疗保留以及更长的戒酒和可卡因使用持续时间相关。与支持性心理治疗（CM）相比，两种积极心理治疗（CBT和TSF）随着时间的推移与可卡因减少有关。在整个治疗过程中，尤其是接受双硫仑治疗的受试者，睾酮和酒精密切相关。结论.对于大部分可卡因依赖者同时也滥用酒精，双硫仑结合门诊心理治疗可能是一种有前途的治疗策略。这项研究强调了（a）寻求治疗的可卡因滥用者中饮酒的重要性，（B）药物依赖者中共病疾病治疗策略的前景，以及（c）心理治疗和药物治疗相结合在药物使用疾病治疗中的重要性。
Aims. To evaluate disulfiram and three forms of manual guided psychotherapy for individuals with cocaine dependence and concurrent alcohol abuse or dependence. Design. Randomized controlled trial. Setting. Urban substance abuse treatment center. Participants. One hundred and twenty-two cocaine/alcohol abusers (27% female; 61% African-American or Hispanic). Interventions. One of five treatments delivered over 12 weeks: cognitive behavioral treatment (CBT) plus disulfiram; Twelve Step facilitation (TSF) plus disulfiram; clinical management (CM) plus disulfiram; CBT plus no medication; TSF plus no medication. Measurements. Duration of continuous abstinence from cocaine or alcohol; frequency and quantity of cocaine and alcohol we by week, verified by urine toxicology and breathalyzer screens. Findings. Disulfiram treatment was associated with significantly better retention in treatment, as well as longer duration of abstinence from alcohol and cocaine use. The two active psychotherapies (CBT and TSF) were associated with reduced cocaine we over time compared with supportive psychotherapy (CM). Cocaine and alcohol we were strongly related throughout treatment, particularly for subjects treated with disulfiram. Conclusions. For the large proportion of cocaine-dependent individuals who also abuse alcohol, disulfiram combined with outpatient psychotherapy may be a promising treatment strategy. This study underlines (a) the significance of alcohol use among treatment-seeking cocaine abusers, (b) the promise of the strategy of treating co-morbid disorders among drug-dependent individuals, and (c) the importance of combining psychotherapy and pharmacotherapy in the treatment of drug use disorders.