COMMUNITY/RELAPSE PEVENTION APPROACHS TO HEROIN ABUSE

提出的研究旨在修改和测试的有效性

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.