Concurrent Alcohol Dependence Among Methadone-Maintained Cocaine Abusers Is Associated With Greater Abstinence
Concurrent Alcohol Dependence Among Methadone-Maintained Cocaine Abusers Is Associated With Greater Abstinence
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DOI：
10.1037/a0022795
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发表时间：
2011-04-01
影响因子：
2.3
通讯作者：
Petry, Nancy M.
中科院分区：
文献类型：
--
作者：
Byrne, Shannon A.;Petry, Nancy M.
多物质滥用者并发酒精依赖（AD）与负面后果相关，尽管它不一定会导致不良的治疗结果。针对可卡因滥用最有效的治疗方法之一是应急管理 (CM)，但很少有研究探讨 AD 对戒断结果的影响，特别是对于美沙酮维持治疗的患者。使用三项可卡因使用 CM 试验的数据，我们比较了美沙酮维持的可卡因依赖患者 (N = 193) 合并或不合并 AD 的基线特征以及治疗后和随访可卡因结果，随机分配到标准护理 (SC) 合并或不合并 CM。患有和不患有阿尔茨海默病的患者具有相似的基线特征，但阿尔茨海默病患者报告饮酒较多。 AD 患者比非 AD 患者实现了更长的可卡因戒断持续时间，并且更有可能在随访时提交可卡因阴性样本。随机接受 CM 的患者比随机接受 SC 的患者取得了更好的结果，但治疗条件和 AD 状态之间没有相互作用。这些研究结果表明，使用可卡因的美沙酮 AD 患者比非 AD 患者更能戒除可卡因，因此不一定被视为更难治疗。
Concurrent alcohol dependence (AD) among polysubstance abusers has been associated with negative consequences, although it may not necessarily lead to poor treatment outcomes. One of the most efficacious treatments for cocaine abuse is contingency management (CM), but little research has explored the impact of AD on abstinence outcomes, particularly among patients in methadone maintenance. Using data from three trials of CM for cocaine use, we compared baseline characteristics and posttreatment and follow-up cocaine outcomes between methadone-maintained, cocaine-dependent patients (N = 193) with and without concurrent AD, randomized to standard care (SC) with or without CM. Patients with and without concurrent AD had similar baseline characteristics, with the exception that AD patients reported more alcohol use. AD patients achieved longer durations of cocaine abstinence and were more likely to submit a cocaine-negative sample at follow-up than non-AD patients. Patients randomized to CM achieved better outcomes than those randomized to SC, but there was no interaction between treatment condition and AD status. These findings suggest that cocaine-using methadone patients with AD achieve greater cocaine abstinence than their non-AD counterparts and should not necessarily be viewed as more difficult to treat.