Reducing benzodiazepine self-administration with contingent reinforcement.
Reducing benzodiazepine self-administration with contingent reinforcement.
复制标题
通过应急强化减少苯二氮卓类药物的自我给药。
DOI：
10.1016/0306-4603(79)90034-0
复制
发表时间：
1979
影响因子：
4.4
通讯作者：
I. Liebson
中科院分区：
文献类型：
--
作者：
M. Stitzer;G. Bigelow;I. Liebson
本研究的目的是确定美沙酮维持病人的药物自我给药是否会受到以减少药物使用为条件的美沙酮门诊特权的影响，并比较两种不同的门诊特权在这方面的强化效果。8名有补充苯二氮卓类药物使用史的美沙酮维持患者参与了研究。为了将非法药物使用转移到治疗诊所，在美沙酮诊所药房给病人开了20毫克/天的地西泮。在评估基线地西泮使用情况后，在6周的时间段内，为患者提供获得单次美沙酮带回家剂量的机会，或者有机会自我调节一天的美沙酮剂量。这些特权取决于在诊所拒绝服用处方的安定。在基线周，要求使用95.6%的可用地西泮剂量。当有带回家的特权时，只有11.2%的人要求服用地西泮，而当有剂量自我控制时，69.7%的人要求服用地西泮。研究表明，美沙酮维持病人的补充药物使用可能受到临床特权的影响，这些特权取决于药物使用的减少。药物带回家特权作为强化物比限制美沙酮剂量的自我控制更有效。美沙酮门诊特权可以作为干预工具，促进药物成瘾者理想的治疗行为改变，特别是促进减少补充药物的使用。
The purpose of the present study was to determine whether drug self-administration by methadone maintenance clients can be influenced by offering methadone clinic privileges contingent upon reductions in drug use, and to compare the reinforcing efficacy in this regard of two different clinic privileges. Eight methadone maintenance clients who had histories of supplemental benzodiazepine use participated. In order to transfer illicit drug use to the treatment clinic, clients were prescribed diazepam, 20 mg/day, at the methadone clinic dispensary. Following assessment of baseline diazepam use, clients were offered, during 6-week blocks of time, either the chance to obtain a single methadone take-home dose or the chance to self-regulate their methadone dose for a single day. These privileges were contingent upon refusing prescribed diazepam at the clinic. During baseline weeks, 95.6% of available diazepam doses were requested. When take-home privileges were available, only 11.2% of diazepam doses were requested, while when dose self-control was available, 69.7% of doses were requested. The study showed that the supplemental drug use of methadone maintenance clients can be influenced by clinic privileges which are available contingent upon reductions of drug use. The medication take-home privilege was more effective as a reinforcer than was limited methadone dosage self-control. Methadone clinic privileges can be used as intervention tools to promote desirable therapeutic behavior change in drug addicts, and in particular to promote reductions in supplemental drug use.