METHADONE ANONYMOUS--BEHAVIORAL THERAPY DEVELOPMENT

美沙酮匿名——行为疗法的发展

• 批准号: 6515762
• 负责人: MARC GALANTER
• 金额: $ 15.86万
• 依托单位: NATHAN S. KLINE INSTITUTE FOR PSYCH RES
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-01 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6515762
• 关键词: behavior therapy; combination therapy; criminal behavior; drug abuse chemotherapy; drug addiction; employment /unemployment; handbook; heroin; high risk behavior /lifestyle; human subject; human therapy evaluation; methadone; outcomes research; patient oriented research; religion; urinalysis

This therapy development study systematically introduces Methadone Anonymous (MA), a 12-step program, into conventional methadone maintenance treatment (MMT) in order to improve the outcome of rehabilitation. A number of problems are apparent in the care of MMT patients: high illicit drug use, lack of motivation for successful community integration, and HIV-risk behavior. These have shown relatively little improvement from the impact of program enhancements like traditional social services and pharmacologic adjuncts. Although the 12-Step model typically involves rejection of dependency-producing agents in treatment, our findings to date suggest that it can enhance the rehabilitation of methadone patients when it embodies the acceptance of methadone maintenance. This benefit can be understood on theoretical grounds on the basis of MA's peer support, voluntary affiliation, and spiritual orientation. However, the feasibility of this MA format has yet to be empirically demonstrated. This project is therefore framed as an R21 grant because it involves the introduction of an approach based on a theoretical model of treatment drawn from another field, namely, the AA maintenance-free approach. The study will proceed as a randomized group design, to include an MA Facilitation (MAF) treatment group (N = 96) and a comparison treatment-as-usual group (N = 96). The specific aims of this study are to: (1) prepare and evaluate an MAF manual for use by staff in the MAF condition; (2) assess the impact of MAF on outcome variables assessed at 6 months (e.g., illicit drug use, HIV risk behaviors); and (3) determine the impact of select patient characteristics (e.g., level of psychiatric distress, motivation) on change in MA attendance and illicit drug use among patients in the MAF condition. Consecutive admissions to the program will be randomly assigned to one of two treatment sites (standard methadone AT with MAF vs. standard MMT only). The development of the MA manual and results of this evaluation will provide pilot data for preparation of an RO1 proposal.

这项治疗开发研究系统地将美沙酮匿名 (MA) 这一 12 步计划引入到传统美沙酮维持治疗 (MMT) 中，以改善康复效果。 MMT 患者的护理中存在一些明显的问题：非法药物使用率高、缺乏成功融入社区的动力以及艾滋病毒危险行为。传统社会服务和药物辅助等计划增强的影响相对较小。尽管12步模型通常涉及在治疗中拒绝产生依赖性的药物，但我们迄今为止的研究结果表明，当它体现了对美沙酮维持治疗的接受时，它可以促进美沙酮患者的康复。这种好处可以从理论上理解，即基于 MA 的同伴支持、自愿归属和精神取向。然而，这种 MA 形式的可行性尚未得到实证证明。因此，该项目被视为 R21 赠款，因为它涉及引入一种基于来自另一个领域的治疗理论模型的方法，即 AA 免维护方法。该研究将以随机分组设计进行，包括 MA 促进 (MAF) 治疗组 (N = 96) 和常规治疗对比组 (N = 96)。本研究的具体目的是：（1）准备并评估 MAF 手册，供处于 MAF 条件下的工作人员使用； (2) 评估 MAF 对 6 个月时评估的结果变量的影响（例如非法药物使用、艾滋病毒危险行为）； (3) 确定特定患者特征（例如精神困扰水平、动机）对 MAF 患者 MA 出勤率和非法药物使用变化的影响。连续入院的计划将被随机分配到两个治疗地点之一（标准美沙酮 AT 与 MAF 对比仅标准 MMT）。 MA 手册的制定和本次评估的结果将为 RO1 提案的准备提供试点数据。