BEHAVIOR REDUCING DRUG ABUSE AND HIV SPREAD

艾滋病毒传播和药物滥用之间存在着一种流行病。 休斯顿(美国第四大城市)的艾滋病病例数量位居第四 艾滋病毒正在迅速传播。滥用可卡因和海洛因都是 很猖獗。主要的治疗预防工作可以通过以下方式进行 实施有效治疗，提高治疗可得性。 精神病学和行为学系的教职员工 科学，德克萨斯大学健康科学中心，提出了一系列 治疗示范研究。我们将研究联合行动 药物干预和行为要求 治疗可卡因和海洛因滥用。其药理参数 美沙酮给药通过最佳组合得到很好的理解 定义不明确。氟西汀(一种有特殊前景的抗抑郁新药) 将被用作可卡因治疗的辅助手段。行为技术 据报道，临床要求的操纵是有效的，但确实 没有得到广泛的接受。这些项目将展示 这些干预措施的明智组合的有效性。独立的 变量将包括这些干预措施的明智组合。 自变量将包括所需的治疗药物和剂量 出勤制度，增援应急措施，以及 优先/非优先结果。因变量将包括； 心理/精神状态，性行为，对毒品的渴望， 成瘾严重程度、医疗状况、药物尿液筛查、依从性和 艾滋病毒状况。小组设计和单一主题设计将相辅相成。这 方法将；(1)在(2)允许的情况下，最大限度地提高结果的一般性 纳入(A)不符合分组设计要求的患者，(B) 很难治疗，但对谁来说是另一种选择 可以实现治疗，和/或(C)谁需要(人数超过我们的 资源)在完成其他项目后继续治疗。 年只有两个公共治疗来源(1个住院，1个门诊) 休斯顿，都是由我们部门控制的。支持此应用程序 将把我们的门诊普查从每月100名患者增加到250名患者。这 这一努力得到了休斯顿卫生局和警方的大力支持 部门、市长办公室、艾滋病毒筛查诊所和直接护理 供应商。

An epidemic exists in the nexus of HIV transmission and drug abuse. Houston, (4th largest U.S. city) has the 4th largest number of AIDS cases and HIV is spreading rapidly. Abuse of both cocaine and heroin is rampant. A major treatment prevention effort can be undertaken by implementing effective treatment and increasing treatment availability. The faculty and staff of the Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, propose a series of treatment demonstration studies. We will examine the joint action of pharmacological interventions and behavioral requirements in the treatment of cocaine and heroin abuse. Pharmacological parameters of methadone administration are well understood by optimal combinations are not well defined. Fluoxetine (a new antidepressant with special promise) will be used as an adjunct in cocaine treatment. Behavioral techniques and manipulation of clinic requirements are reported effective, but do not have widespread acceptance. These projects will demonstrate the efficacy of the judicious combination of these interventions. Independent variables will include judicious combination of these interventions. Independent variables will include Therapeutic drug and dose, required attendance regimen, contingencies for reinforcement, and preferred/nonpreferred consequences. Dependent variables will include; psychological/Psychiatric status, sexual behavior, drug craving, addiction severity, medical status, drug urine screens, compliance, and HIV status. Group and Single-Subject Designs will be complementary. this approach will; (1) maximize generality of results while, (2) permitting inclusion of (a) patients not meeting group design requirements, (b) who are difficult to treat but for whom demonstrations of alternative treatments can be achieved, and/or (c) who require (in numbers beyond our resources) continued treatment after completing other projects. There are only two public treatment sources (1 in-,1 outpatient) in Houston, both controlled by our Department. Support of this application will increase our outpatient census from 100 to 250 patients/month. This effort is strongly supported by the houston Health Department, Police Department, Mayors Office, HIV screening clinics, and direct care providers.