PSYCHOLOGICAL AND METHODOLOGICAL ISSUES IN SUBSTANCE ABUSE TREATMENT/RESEARCH

药物滥用治疗/研究中的心理和方法问题

• 批准号: 2571623
• 负责人: K L PRESTON
• 金额: --
• 依托单位: NATIONAL INSTITUTE ON DRUG ABUSE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/2571623
• 关键词: HIV infections; alcoholism /alcohol abuse; antisocial personality; behavior prediction; clinical research; clinical trials; cocaine; drug abuse chemotherapy; drug addiction; family genetics; heroin; high risk behavior /lifestyle; human subject; human therapy evaluation; methadone; psychological reinforcement; urinalysis

Psychological and methodological issues in substance abuse treatment/research are under investigation as part of the clinical trials evaluating cocaine and opioid abuse treatments. In addition to the projects below, research is underway to evaluate the relationships between HIV risk behaviors and HIV status and treatment outcome and methods for measuring craving. One area of interest is the identification of predictors of drug abuse treatment outcome. Intake variables from 96 polydrug users who had participated in voucher-based reinforcement therapy clinical trials were evaluated to determine which predicted clinically significant periods of abstinence. Logistic regression analysis revealed two significant pretreatment by study condition interactions: lower baseline use by voucher reinforcement therapy and non anti-social personality diagnoses by voucher reinforcement therapy. In a smaller subset of 19 subjects, drug use data collected during a 5-week baseline period were analyzed to evaluate its potential utility to predict treatment outcome. Cocaine use in the first and last baseline visit, first and last baseline week, and mean across the baseline was compared in subjects who responded with sustained abstinence and patients who did not. Overall, treatment responders used significantly less cocaine in baseline than non- responders; differences in cocaine use were not evident in the first visit or week, but were significant in the last visit and week of baseline. Cocaine use differentially changed during baseline: responders tended to decrease use across the baseline while non-responders tended to increase use over the same period. Further research is underway to identify risk typologies that could improve response to treatment for high baseline cocaine users and individuals diagnosed with anti-social personality disorder. Additional studies have focused on the specificity of familial transmission of alcohol and drug dependence and methods for monitoring cocaine use. Evaluation of the family histories of methadone maintenance patients enrolled in our clinical trials revealed that their parents and siblings had higher rates of drug and alcohol dependence than the general population. Evidence was found to support familial transmission of substance use disorder; however, transmission was not specific for alcohol or drugs. Differences between rates of transmission in males and females were noted. Virtually all commercial and investigational monitoring of cocaine use has been done by detecting the presence of the cocaine metabolite benzoylecognine in urine. Alternative methods of monitoring drug use are being evaluated.

药物滥用的心理和方法问题 作为临床试验的一部分，正在研究治疗/研究 评估可卡因和阿片类药物滥用治疗。 除了有 下面的项目，研究正在进行中，以评估关系 艾滋病毒风险行为和艾滋病毒状况与治疗结果之间的关系， 测量渴望的方法。 一个令人感兴趣的领域是确定药物滥用的预测因素 治疗结果 96名多种药物使用者的摄入变量， 参加了基于凭证的强化治疗临床试验， 评估以确定哪些预测的临床显著期 禁欲 Logistic回归分析显示，两个显著 治疗前与研究条件的相互作用：基线使用量较低， 凭证强化疗法与非反社会人格诊断 通过代金券强化疗法 在19名受试者的较小子集中， 对5周基线期内收集的药物使用数据进行分析， 评估其预测治疗结果的潜在效用。 可卡因 首次和末次基线访视、首周和末周基线访视时使用， 和基线平均值进行了比较， 持续禁欲的人和没有禁欲的人 总体而言，治疗 应答者在基线时使用的可卡因显著少于非应答者。 反应者;可卡因使用的差异在第一个反应者中不明显。 访视或周，但在最后一次访视和周 基线。 基线期间的复方新诺明使用差异变化：应答者 倾向于减少基线使用，而无应答者倾向于 在同一时期增加使用。 进一步的研究正在进行中， 确定可以改善治疗反应的风险类型 高基线可卡因使用者和被诊断为反社会的个人 人格障碍 更多的研究集中在家族性疾病的特异性上。 酒精和药物依赖的传播和监测方法 可卡因的使用 美沙酮维持治疗家族史的评价 参加我们临床试验的患者透露，他们的父母和 兄弟姐妹的药物和酒精依赖率高于一般 人口 有证据表明， 物质使用障碍;然而，传播并不是特定于 酒精或毒品。 男性和女性之间的传播率差异 注意到女性。 几乎所有的商业和研究 对可卡因使用的监测是通过检测 尿中可卡因代谢物苯甲酰麦角碱。 的替代方法 正在评估对毒品使用情况的监测。