Sustained cocaine abstinence in methadone maintenance patients through voucher-based reinforcement therapy.
Sustained cocaine abstinence in methadone maintenance patients through voucher-based reinforcement therapy.
复制标题
通过基于凭证的强化治疗，美沙酮维持患者持续戒除可卡因。
DOI：
10.1001/archpsyc.1996.01830050045007
复制
发表时间：
1996
影响因子：
--
通讯作者：
K. Preston
中科院分区：
文献类型：
--
作者：
K. Silverman;S. Higgins;R. Brooner;I. Montoya;I. Montoya;E. Cone;C. Schuster;C. Schuster;K. Preston
背景
BACKGROUND
Chronic cocaine abuse remains a serious and costly public health problem. This study assessed the effectiveness of a voucher-based reinforcement contingency in producing sustained cocaine abstinence.
METHODS
A randomized controlled trial compared voucher-based reinforcement of cocaine abstinence to noncontingent voucher presentation. Patients were selected from 52 consecutively admitted injecting heroin abusers in a methadone maintenance treatment program. Patients with heavy cocaine use during baseline period (N = 37) participated. Except where otherwise indicated, the term cocaine abuse is used in this article in a generic sense and not according to the DSM-III-R definition. Patients exposed to abstinence reinforcement received a voucher for each cocaine-free urine sample (ie, negative for benzoylecgonine) provided three times per week throughout a 12-week period; the vouchers had monetary values that increased as the number of consecutive cocaine-free urine samples increased. Control patients received noncontingent vouchers that were matched in pattern and amount to the vouchers received by patients in the abstinence reinforcement group.
RESULTS
Patients receiving vouchers for cocaine-free urine samples achieved significantly more weeks of cocaine abstinence (P = .007) and significantly longer durations of sustained cocaine abstinence (P = .001) than controls. Nine patients (47%) receiving vouchers for cocaine-free urine samples achieved between 7 and 12 weeks of sustained cocaine abstinence; only one control patient (6%) achieved more than 2 weeks of sustained abstinence. Among patients receiving vouchers for cocaine-free urine samples, those who achieved sustained abstinence ( > or = 5 weeks) had significantly lower concentrations of benzoylecgonine in baseline urine samples than those who did not achieve sustained abstinence (P < or = .01). Patients receiving voucher reinforcement rated the overall treatment quality significantly higher than controls (P = .002).
CONCLUSION
Voucher-based reinforcement contingencies can produce sustained cocaine abstinence in injecting polydrug abusers.
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影响因子：
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作者：
Carroll,KM;Rounsaville,BJ;Nich,C;Gordon,LT;Wirtz,PW;Gawin,F
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DOI：
10.1176/ajp.148.9.1218
发表时间：
1991
期刊：
The American journal of psychiatry
影响因子：
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作者：
Higgins,ST;Delaney,DD;Budney,AJ;Bickel,WK;Hughes,JR;Foerg,F;Fenwick,JW
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Fenwick,JW
美沙酮维持治疗患者可卡因滥用：有有效的治疗策略吗？
影响因子：
2.8
作者：
Rawson,RA;McCann,MJ;Hasson,AJ;Ling,W
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Ling,W
患者自我报告的药物使用情况作为治疗状态函数的有效性。
影响因子：
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作者：
Sherman,MF;Bigelow,GE
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Bigelow,GE
可卡因滥用治疗：当前策略回顾。
DOI：
10.1016/s0899-3289(10)80026-4
发表时间：
1991
期刊：
Journal of substance abuse
影响因子：
--
作者：
Rawson,RA;Obert,JL;McCann,MJ;Castro,FG;Ling,W
通讯作者：
Ling,W