Abstinence-contingent recovery housing and reinforcement-based treatment following opioid detoxification.
Abstinence-contingent recovery housing and reinforcement-based treatment following opioid detoxification.
复制标题
阿片类药物戒毒后的戒断康复住房和强化治疗。
DOI：
10.1111/j.1360-0443.2011.03750.x
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Stitzer,Maxine
中科院分区：
文献类型：
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作者：
Tuten,Michelle;DeFulio,Anthony;Jones,HendréeE;Stitzer,Maxine
AimsTo conduct a randomized，controlled trial of abstinence-contingent recovery housing delivered with or without intensive day treatment among exiting roadside opioid detoxification. Design随机分配到三种条件之一：恢复住房单独（RH），abstinence-contingent recovery housing with reinforcement-based treatment RBT（RH + RBT）或常规护理（UC）. RH和RH + RBT参与者根据戒毒情况获得12周的有偿康复住房。 RH + RBT参与者还接受了26周的RBT，与恢复住房同时开始。 在治疗入组后1、3和6个月进行评估。设置马里兰州巴尔的摩的门诊患者无药物滥用治疗计划。完成药物辅助阿片类药物脱毒的患者（n= 243）。测量主要结局是药物戒断（阿片类药物和可卡因阴性尿液，并且在过去30天内没有自我报告阿片类药物或可卡因使用）。 次要结果包括在所有时间点（1，3和6个月）的禁欲，恢复住房和employees.FindingsOverall戒毒率分别为50% RH + RBT，37% RH和13% UC（P<0.001）。 在6个月时，RH + RBT参与者比UC参与者更有可能达到禁欲标准（37%vs20%，P = 0.016）。 在恢复住房中的停留时间介导了戒断结果，RH + RBT（49.5天）长于RH（32.2天;P<0.002）。 增加强化的“强化治疗”行为咨询进一步改善了治疗效果，部分原因是促进了更长的恢复住院时间。
AimsTo conduct a randomized, controlled trial of abstinence‐contingent recovery housing delivered with or without intensive day treatment among individuals exiting residential opioid detoxification.DesignRandom assignment to one of three conditions: recovery housing alone (RH), abstinence‐contingent recovery housing with reinforcement‐based treatment RBT (RH + RBT) or usual care (UC). RH and RH + RBT participants received 12 weeks of paid recovery housing contingent upon drug abstinence. RH + RBT participants also received 26 weeks of RBT, initiated concurrently with recovery housing. Assessments were conducted at 1, 3 and 6 months after treatment enrollment.SettingOut‐patient drug‐free substance abuse treatment program in Baltimore, Maryland.ParticipantsPatients (n= 243) who completed medication‐assisted opioid detoxification.MeasurementsPrimary outcome was drug abstinence (opioid‐ and cocaine‐negative urine and no self‐reported opioid or cocaine use in the previous 30 days). Secondary outcomes included abstinence at all time‐points (1, 3 and 6 months), days in recovery housing and employment.FindingsOverall rates of drug abstinence were 50% for RH + RBT, 37% for RH and 13% for UC (P< 0.001). At 6 months, RH + RBT participants remained more likely to meet abstinence criteria than UC participants (37% versus 20%,P= 0.016). Length of stay in recovery housing mediated abstinence outcomes and was longer in RH + RBT (49.5 days) than in RH (32.2 days;P< 0.002).ConclusionsAbstinence‐contingent recovery housing improves abstinence in opioid‐dependent adults following medication‐assisted detoxification. The addition of intensive ‘reinforcement‐based treatment’ behavioural counseling further improves treatment outcomes, in part by promoting longer recovery house stays.