EVALUATION OF NON-PHARMACOLOGICAL TREATMENTS OF SUBSTANCE ABUSE

今年完成了两个主要项目，其中非药物 对药物滥用的治疗进行了测试。 在第一个项目中， 行为干预，应急管理，被用来治疗 一组美沙酮维持治疗患者的可卡因使用情况。 在 第二个项目的影响强度的咨询可卡因 评价了依赖性。 应急管理程序的有效性， 在阿片类药物依赖者中评价了持续的可卡因戒断 参与美沙酮维持治疗计划的可卡因滥用者。 37名经常使用可卡因的美沙酮维持治疗受试者 在5周的基线期内， 应急管理组或对照组。 受试者 应急管理小组赚取凭单（可兑换货物 或服务）用于提供无可卡因尿样（即，样品 对苯甲酰芽子碱呈阴性）;代金券的价值随着 连续无可卡因尿样的数量增加。 受试者 对照组收到价值相当的代金券， 与应急中受试者的频率大致相同 管理条件，但独立于存在或不存在 不含可卡因的尿液 初步结果显示， 应急管理小组的工作时间大大延长， 持续戒断可卡因的人比那些 对照组 咨询是几乎所有药物滥用治疗的一个重要组成部分; 因此，需要对咨询程序进行标准化和评估 为了建立有效的治疗，咨询是否是唯一的 治疗或与药物治疗联合给予。 12周 最近完成了一项研究，其中标准化的 个人认知/行为/人际关系咨询计划 根据指定的治疗手册给药，给药两次 每周、每周一次或每两周进行比较。 结果 措施包括可卡因和其他药物使用（通过自我报告和尿液 毒理学）、可卡因渴求、心理状态和社会心理 功能 初步分析表明， 每周两次治疗组的初始脱落率，但无显著差异 12个月后两组药物使用结果指标的差异 数周的治疗。 目前正在对该手册进行改编， 组治疗形式。

Two major projects were completed this year in which non-pharmacological treatments of substance abuse were tested. In the first project, a behavioral intervention, contingency management, was used to treat cocaine use among a group of methadone maintenance patients. In the second project the effects of intensity of counseling in cocaine dependence was evaluated. The effectiveness of contingency management procedures designed to produce sustained cocaine abstinence was evaluated in opioid-dependent cocaine abusers participating in a methadone maintenance program. Thirty-seven methadone maintenance subjects who used cocaine regularly during a 5-week baseline period were randomly assigned to either a contingency management group or to a yoked control group. Subjects in the contingency management group earned vouchers (exchangeable for goods or services) for providing cocaine-free urine samples (i.e., samples negative for benzoylecgonine); the value of the vouchers increased as the number of consecutive cocaine-free urine samples increased. Subjects in the yoked control group received vouchers of comparable value and at approximately the same frequency as subjects in the contingency management condition, but independent of the presence or absence of cocaine-free urines. Preliminary results indicate that the persons in the contingency management group achieved substantially longer periods of sustained abstinence from cocaine use than persons in the yoked control group. Counseling is an important element of virtually all drug abuse treatment; thus standardization and evaluation of counseling procedures is needed to establish effective treatment, whether counseling is the sole treatment or is given in combination with pharmacotherapy. A 12-week study was recently completed in which the efficacy of a standardized individual Cognitive/Behavioral/Interpersonal counseling program administered according to a specified therapy manual, given either twice weekly, once weekly, or every two weeks, were compared. Outcome measures included cocaine and other drug use (by self-report and urine toxicology), cocaine craving, psychological state, and psychosocial functioning. Preliminary analysis indicated that there were fewer initial drop-outs in the twice a week treatment group, but no significant differences in drug use outcome measures between groups after twelve weeks of treatment. The manual is currently being adapted for use in a group treatment format.