Employment-Based Addiction Pharmacotherapy

基于就业的成瘾药物治疗

• 批准号: 6852277
• 负责人: Kenneth Silverman
• 金额: $ 62.35万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6852277
• 关键词: AIDS education /prevention; behavioral /social science research tag; chemotherapy; clinical research; cocaine; drug /alcohol abstinence; drug abuse chemotherapy; drug abuse therapy; drug addiction; drug detection; employment /unemployment; high risk behavior /lifestyle; human subject; human therapy evaluation; intravenous drug abuse; medical rehabilitation related tag; naltrexone; opiate alkaloid; patient oriented research; public assistance; reinforcer; substance abuse related behavior; therapy compliance; training; urinalysis; vocational rehabilitation; work site

DESCRIPTION (provided by applicant): Heroin addiction can have devastating social, medical and economic consequences. Methadone maintenance is an effective treatment for heroin addiction, but only about 20 percent of opiate dependent individuals receive it. Naltrexone is an opiate antagonist that could provide an extraordinarily effective alternative for many individuals. However, its utility has been limited because most individuals refuse it. A randomized study is planned over 5 years to evaluate the effectiveness of the Therapeutic Workplace in promoting naltrexone ingestion and abstinence in unemployed opiate-dependent injection drug users. The Therapeutic Workplace is a novel employment-based intervention that uses salary for work to reinforce clinically important behavior change. Drug abuse patients are hired and paid in this model workplace. To promote clinically important behaviors, salary is arranged contingent both on work and on the emission of those behaviors. Participants will be offered an opioid detoxification and naltrexone induction. Participants who complete the naltrexone induction will be randomly assigned to one of three groups. All groups will be invited to work in the Therapeutic Workplace and prescribed naltrexone for 26 weeks. The groups will differ in the contingencies imposed to work and earn salary. "Work Plus Naltrexone Contingency" participants will be required to ingest naltrexone to work, and will receive a brief pay decrease for missing a dose. "Work Plus Naltrexone and Abstinence Contingency" participants will be required to ingest naltrexone to work, and will receive a brief pay decrease for missing a dose of naltrexone or for providing an opiate or cocaine positive urine sample. "Work Plus Naltrexone Prescription" participants will be prescribed naltrexone, but will not be required to ingest it to work. Critical measures of opiate and cocaine use and HIV risk behaviors will be assessed. This study will provide a rigorous evaluation of a novel employment based intervention, the Therapeutic Workplace, to promote naltrexone ingestion and drug abstinence in a population of injection drug users who are at considerable risk of spreading or contracting HIV infection.

描述（由申请人提供）：海洛因成瘾可能产生毁灭性的社会，医疗和经济后果。美沙酮维持治疗是海洛因成瘾的有效治疗方法，但只有大约20%的阿片类药物依赖者接受美沙酮。纳洛酮是一种阿片类药物拮抗剂，可以为许多人提供非常有效的替代药物。然而，它的效用已被限制，因为大多数人拒绝it.A随机研究计划超过5年，以评估的有效性的治疗工作场所在促进纳洛酮摄入和禁欲的失业阿片类药物依赖注射吸毒者。治疗性工作场所是一种新型的基于就业的干预措施，它使用工作工资来加强临床上重要的行为改变。药物滥用患者在这个模范工作场所被雇用并获得报酬。为了促进临床上重要的行为，工资是根据工作和这些行为的排放来安排的。参与者将被提供阿片类药物解毒和纳洛酮诱导。完成纳洛酮诱导的参与者将被随机分配到三组之一。所有小组将被邀请在治疗工作场所工作，并规定纳洛酮26周。这两个群体在工作和赚取工资所面临的意外情况方面会有所不同。“工作加纳洛酮应急”参与者将被要求摄入纳洛酮工作，并将收到一个简短的工资减少错过一个剂量。“工作加纳洛酮和禁欲应急”的参与者将被要求摄入纳洛酮工作，并将收到一个简短的工资减少错过一个剂量的纳洛酮或提供鸦片或可卡因阳性尿样。“工作加纳洛酮处方”参与者将被规定纳洛酮，但将不需要摄入它的工作。将评估阿片类药物和可卡因使用以及艾滋病毒风险行为的关键措施。这项研究将提供一个新的就业为基础的干预措施，治疗工作场所，以促进纳洛酮摄入和药物戒断的注射吸毒者谁是在相当大的风险传播或感染艾滋病毒感染的人口进行严格的评估。