METHADONE ANONYMOUS--BEHAVIORAL THERAPY DEVELOPMENT

美沙酮匿名——行为疗法的发展

• 批准号: 6607507
• 负责人: MARC GALANTER
• 金额: $ 15.92万
• 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 2004-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6607507
• 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.

这项治疗发展研究系统地介绍了美沙酮匿名（MA），一个12步程序，到传统的美沙酮维持治疗（MMT），以改善康复的结果。一些问题是显而易见的，在MMT患者的护理：高非法药物使用，缺乏成功的社区整合的动机，和艾滋病毒的危险行为。这些都显示出相对较小的改善，如传统的社会服务和药理学的影响程序增强。虽然12步模型通常涉及拒绝依赖产生剂的治疗，我们的研究结果表明，它可以提高美沙酮患者的康复时，它体现了接受美沙酮维持。这种益处可以在理论上理解，基于MA的同伴支持，自愿加入和精神取向。然而，这一千年评估模式的可行性还有待经验证明。因此，该项目被定为R21赠款，因为它涉及采用一种基于另一领域的治疗理论模式的方法，即AA免抚养方法。本研究将采用随机分组设计，包括MA促进（MAF）治疗组（N = 96）和对照常规治疗组（N = 96）。本研究的具体目的是：（1）编写和评价MAF手册，供MAF条件下的工作人员使用;（2）评估MAF对6个月时评估的结局变量的影响（例如，非法药物使用、HIV危险行为）;以及（3）确定选定患者特征的影响（例如，精神痛苦水平、动机）对MAF患者MA出勤率和非法药物使用的变化的影响。该计划的连续入院者将被随机分配到两个治疗中心之一（标准美沙酮AT联合MAF与仅标准MMT）。千年生态系统评估手册的编写和评估结果将为编制一份RO 1提案提供试点数据。