COMMUNITY/RELAPSE PEVENTION APPROACHS TO HEROIN ABUSE

这项拟议的研究旨在修改和测试 社区强化方法(CRA)在吸毒人群中的应用。这个 这项研究的两个主要目标将是测试有无复发的CRA 预防技术，与标准治疗方案相比。CRA 是由内森·阿兹林开发的，用于治疗酒精中毒 在先前的成果研究中得到了重大支持。《寻找工作》 俱乐部，CRA的一个组成部分，已经为海洛因成瘾者进行了修改，并已经 已经被证明是有效的。我们将修改海洛因的CRA程序 并添加特定的技术以减少过早辍学，提高 保持和减少复发的有害影响。双硫胺 CRA采用的合规程序将适用于海洛因依赖者 有带回家特权的美沙酮。 综上所述，拟议的研究将在以下方面提供重要的新知识 有几个方面。(1)这将是CRA的第一次临床试验， 海洛因滥用人群。(2)它将是最大的受控城市之一 对吸毒者进行任何治疗程序的试验。(3)将会增加 西班牙裔海洛因滥用患者的治疗知识和意愿 允许比较西班牙裔和盎格鲁人群体以及亚文化 分析。(4)它将提供确定配置文件所需的信息 对所研究的各种治疗方法做出最佳反应，从而取得进展 转向更复杂的方案，将患者与治疗相匹配。(6) 它将开发一种独特的方法来监测美沙酮的遵守情况 带回家的剂量，目的是减少非法美沙酮 转移视线。(7)最后，该研究将提供人性化的治疗 可以很容易地传播并传授给其他治疗提供者。

The proposed study is designed to modify and test the efficacy of the Community Reinforcement Approach (CRA) in a drug abusing population. The two major aims of the study will be to test CRA with and without Relapse Prevention techniques, as compared to a standard treatment package. CRA was developed by Nathan Azrin for the treatment of alcoholism and has received significant support in prior outcome studies. The Job Finding Club, one component of CRA, has been modified for heroin addicts and has been shown to be effective. We will modify CRA procedures for heroin abusers and add specific techniques to reduce early drop out, improve retention and decrease the harmful effects of relapse. The disulfiram compliance procedure used in CRA will be applied to heroin addicts on methadone who have take home privileges. In summation, the proposed study will provide important new knowledge in several areas. (1) It will be the first clinical trial of the CRA with a heroin abusing population. (2) It will be one of the largest controlled trials of any treatment procedures for drug abusers. (3) It will increase knowledge of treatment for Hispanic heroin abusing patients and would permit comparisons of Hispanic and Anglo groups, as well as subcultural analyses. (4) It will provide information needed to determine the profiles of optimal responders to the various treatments studied, allowing progress toward more sophisticated schemes for matching patients to treatments. (6) It will develop a unique method for monitoring compliance with methadone take home doses, with the intended purpose of reducing illicit methadone diversion. (7) Finally, the study will provide manualized treatment that can be easily disseminated and taught to other treatment providers.