Comparison of pharmacological treatments for opioid-dependent adolescents - A randomized controlled trial.
Comparison of pharmacological treatments for opioid-dependent adolescents - A randomized controlled trial.
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DOI：
10.1001/archpsyc.62.10.1157
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发表时间：
2005-10-01
影响因子：
--
通讯作者：
Brooklyn, J
中科院分区：
文献类型：
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作者：
Marsch, LA;Bickel, WK;Brooklyn, J
背景：过去十年，青少年中海洛因和其他阿片类药物的流行率显着增加；然而，实际上还没有进行研究来确定针对该人群的有效治疗方法。 目的：评估 2 种药物疗法（部分阿片类药物激动剂盐酸丁丙诺啡和中枢活性 α(2-) 肾上腺素能阻滞剂盐酸可乐定）在阿片类药物依赖青少年戒毒中的相对疗效。 设计、环境和患者：A 2001 年 10 月至 2003 年 12 月在大学研究诊所进行的双盲、双模拟、平行组随机对照试验。患者是 36 名符合 DSM-IV 阿片类药物依赖标准的青少年志愿者样本（年龄为 13-18 岁）。干预措施：参与者被随机分配接受为期 28 天的门诊药物辅助戒断治疗，其中 丁丙诺啡或可乐定。这两种药物均提供每周三次的行为咨询和基于阿片类药物戒断的激励措施。戒毒后，所有参与者都有机会继续接受阿片类拮抗剂盐酸纳曲酮治疗。主要结果指标：治疗保留、阿片类药物戒断和人类免疫缺陷病毒风险行为，以及戒断和药物效应的测量。结果：相对于接受丁丙诺啡治疗的青少年，接受丁丙诺啡治疗的青少年保留治疗的比例显着更高（72%） 可乐定 (39%) (P
Context: The prevalence of heroin and other opioid use has markedly increased among adolescents in the last decade; however, virtually no research has been conducted to identify effective treatments for this population.Objective: To evaluate the relative efficacy of 2 pharmacotherapies, the partial opioid agonist buprenorphine hydrochloride and the centrally active alpha(2-)adrenergic blocker clonidine hydrochloride, in the detoxification of opioid-dependent adolescents.Design, Setting, and Patients: A double-blind, double-dummy, parallel-groups randomized controlled trial conducted in a university-based research clinic from October 2001 to December 2003. Patients were a volunteer sample of 36 adolescents who met DSM-IV criteria for opioid dependence (ages 13-18 years eligible).Interventions: Participants were randomly assigned to a 28-day, outpatient, medication-assisted withdrawal treatment with either buprenorphine or clonidine. Both medications were provided along with thrice weekly behavioral counseling and incentives contingent on opiate abstinence. Postdetoxification, all participants were offered the opportunity for continued treatment with the opiate antagonist, naltrexone hydrochloride.Main Outcome Measures: Treatment retention, opiate abstinence, and human immunodeficiency virus risk behavior, along with measures of withdrawal and medication effects.Results: A significantly greater percentage of adolescents who received buprenorphine were retained in treatment (72%) relative to those who received clonidine (39%) (P