The brief abstinence test: voucher-based reinforcement of cocaine abstinence
The brief abstinence test: voucher-based reinforcement of cocaine abstinence
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DOI：
10.1016/s0376-8716(99)00090-3
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发表时间：
2000-02-01
影响因子：
4.2
通讯作者：
Stitzer, ML
中科院分区：
文献类型：
--
作者：
Robles, E;Silverman, K;Stitzer, ML
本研究评估了短暂戒断强化程序对美沙酮维持患者开始戒断可卡因的有效性。在测试周的周一，如果72名吸食可卡因的美沙酮患者在周三采集的尿液样本表明他们在两天内没有吸食可卡因，就可以获得100美元的代金券。若周一至周三尿液苯甲酰lecgonine浓度下降50%（定量标准）或周三尿液样本浓度小于或等于300 ng/ml，则视为患者戒断，并给予代金券。总体而言，79%的研究患者在测试周的周一至周三期间，尿液分析显示他们没有使用可卡因。在数据完整的子样本（n = 50）中，测试周的周一至周三（84%）戒除可卡因的患者明显多于测试周之前（36%）或之后（32%）的周一至周三。此外，虽然几乎所有患者（94%）在测试周的周一至周三降低了他们的苯甲酰lecgonine浓度，但在测试周的前一周（56%）或后一周（48%）的周一至周三，苯甲酰lecgonine浓度明显降低的患者较少。这种高效的方法可以在需要可靠的戒断开始时应用于临床，无论是在暂时的基础上（如清醒抽样）还是在长期干预的开始。也有可能使用简短戒断测试作为实验模型来评估其他治疗干预措施对戒断开始的影响。(C) 2000爱思唯尔科学爱尔兰有限公司版权所有。
This study assessed the effectiveness of a brief abstinence reinforcement procedure for initiating cocaine abstinence in methadone maintenance patients. On Monday of the test week, 72 cocaine-abusing methadone patients were offered a $100 voucher if urine samples collected on Wednesday indicated that they had abstained from cocaine across that 2-day period. A patient was considered abstinent and the voucher delivered if the urine benzoylecgonine concentration decreased by 50% from Monday to Wednesday (quantitative criterion) or if the concentration of Wednesday's urine sample was less than or equal to 300 ng/ml. Overall, 79% of study patients showed urinalysis evidence of abstention from cocaine between Monday and Wednesday of the test week. In a subsample with complete data (n = 50), significantly more patients abstained from cocaine from Monday to Wednesday of the test week (84%) than from Monday to Wednesday of the week before (36%) or after (32%) the test week. Furthermore, while almost all patients (94%) decreased their benzoylecgonine concentration from Monday to Wednesday of the test week, significantly fewer patients' benzoylecgonine concentrations decreased from Monday to Wednesday of the week before (56%) or after (48%) the test week. This highly efficacious procedure may have clinical application where reliable abstinence initiation is desired, either on a temporary basis (e.g. sobriety sampling) or at the start of longer-term interventions. It may also be possible to use the brief abstinence test as an experimental model to assess the effects of other therapeutic interventions on abstinence initiation in treatment settings. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.