A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users
A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users
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DOI：
10.1901/jaba.2007.40-387
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发表时间：
2007-09-01
影响因子：
2.9
通讯作者：
Kolodner, Kenneth
中科院分区：
文献类型：
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作者：
Silverman, Kenneth;Wong, Conrad J.;Kolodner, Kenneth
高强度和长时间的戒断强化可以促进戒毒，但可能难以融资。就业可能是安排高强度和长时间禁欲强化的工具。本研究确定以就业为基础的戒断强化是否可以增加在美沙酮治疗期间注射毒品和使用可卡因的成年人的可卡因戒断。参与者可以每个工作日在工作场所工作4小时，每小时可以获得约10美元的代金券；他们被要求提供常规尿样。在最初的4周内参加工作并提供可卡因阳性尿样的参与者被邀请工作26周，并被随机分配到戒酒和工作（n = 28）组或只工作（n = 28）组。戒酒和工作的参与者必须提供显示戒毒的尿样才能工作并维持最高工资。只工作的参与者可以独立于他们的尿液分析结果工作。禁欲和工作的参与者提供的可卡因阴性尿样（29%）比只工作的参与者（10%）多（p = 0.004; OR = 5.80, 95% CI = 2.03-16.56）。以就业为基础的戒断强化可以增加可卡因戒断。
High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = .004; OR = 5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence.