EVALUATION OF NON-PHARMACOLOGICAL TREATMENTS OF SUBSTANCE ABUSE

药物滥用非药物治疗的评估

• 批准号: 5201689
• 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/5201689
• 关键词: behavior modification; cocaine; drug abuse therapy; drug addiction; drug detection; human subject; human therapy evaluation; intravenous drug abuse; longitudinal human study; methadone; patient care management; psychological reinforcement; psychotherapy; substance abuse related disorder; urinalysis

The section has continued to investigate two major non-pharmacological treatments of substance abuse, contingency management and cognitive/behavioral therapy. Abstinence reinforcement contingencies, rooted in the Experimental and Applied Analysis of Behavior, are based on the empirically-derived assumption that drug abuse is operant behavior maintained and modifiable by its consequences and thus sensitive to the types of environmental variables which have been shown in laboratory and applied research to affect a wide range of operant behaviors. Our first study validated the application of the principle of reinforcement, the central principle in operant conditioning, to the treatment of cocaine use disorder. Our second major study was completed in the past year. Participants were inner-city, intravenous, polydrug abusers receiving standard methadone maintenance treatment. Experimental patients were exposed to reinforcement contingencies in which they received vouchers for cocaine-free urines. The vouchers had monetary values and were exchangeable for goods and services designed to support drug-free lifestyles. A unique and important aspect of the procedure is that the monetary value of the vouchers increased as the number of consecutive cocaine-free urines increased; cocaine-positive urines reset the value of the next voucher back to the initial low value. Control patients received noncontingent vouchers that were matched in pattern and amount to the vouchers received by abstinence reinforcement patients. Patients exposed to the abstinence reinforcement contingencies achieved significantly longer periods of sustained cocaine abstinence than controls. To date our studies have shown that voucher-based reinforcement contingencies can produce sustained cocaine abstinence, even in inner-city, intravenous, polydrug abusers who historically have been very difficult to treat by other means, and that the schedule of reinforcement is an important factor in determining treatment outcome. Two follow-up studies in methadone maintenance patients are in progress. The contingency management procedure is also being applied in a study to improve compliance with naltrexone treatment

该部门继续调查两个主要的非药理学 药物滥用的治疗、应急管理和 认知/行为疗法。 禁欲强化突发事件， 植根于行为的实验和应用分析，基于 基于经验得出的假设，即药物滥用是操作行为 通过其后果维持和修改，因此对 已在实验室和环境中显示的环境变量类型 应用研究影响广泛的操作行为。 我们的第一个 研究验证了强化原理的应用， 操作性条件反射的中心原则，用于治疗可卡因 使用障碍。 我们的第二项主要研究已于去年完成。 参与者是市中心、静脉注射、多种药物滥用者，接受治疗 标准美沙酮维持治疗。 实验患者为 面临加固突发事件，他们收到了优惠券 用于不含可卡因的尿液。 这些优惠券具有货币价值，并且 可兑换旨在支持无毒品的商品和服务 生活方式。 该程序的一个独特且重要的方面是 优惠券的货币价值随着连续使用次数的增加而增加 不含可卡因的尿液增加；可卡因阳性尿液重置数值 下一张优惠券的金额恢复到初始低值。 对照患者 收到模式和金额匹配的非或有凭证 戒断强化患者收到的代金券。 患者 暴露在禁欲强化意外事件中所达到的效果 持续戒除可卡因的时间明显长于 控制。 迄今为止，我们的研究表明，基于凭证的 强化意外事件可以产生持续的可卡因戒断， 即使是在市中心的静脉注射、多种药物滥用者中，他们历史上也曾吸毒 通过其他方式治疗非常困难，并且时间表 强化是决定治疗结果的重要因素。 两项针对美沙酮维持治疗患者的后续研究正在进行中。 应急管理程序也被应用于一项研究中 提高纳曲酮治疗的依从性