Reinforcing Exercise in Cocaine Abusers

加强可卡因滥用者的锻炼

• 批准号: 8516483
• 负责人: NANCY M PETRY
• 金额: $ 56.04万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8516483
• 关键词: Abstinence; Accounting; Address; Adherence; Aerobic; Affect; Aftercare; Alcohol or Other Drugs use; Alcohols; American; Anxiety; Area; Behavior; Blood Pressure; Body mass index; Cardiovascular system; Cigarette Smoker; Cocaine; Cocaine Abuse; Contracts; Controlled Study; Data; Dimensions; Drug abuse; Drug usage; Evaluation; Exercise; Family; Gender; Goals; Health; Illicit Drugs; Individual; Intervention; Lead; Link; Marijuana; Measures; Mediating; Medical; Mental Depression; Methods; Moods; Opioid; Outcome; Outpatients; Participant; Patients; Personal Satisfaction; Pharmaceutical Preparations; Physical Fitness; Physical activity; Physicians; Prize; Procedures; Process; Psychological reinforcement; Psychologist; Race; Randomized; Regimen; Relative (related person); Research; Resistance; Sample Size; Self Efficacy; Smoking; Specimen; Sports Medicine; Stress; Symptoms; Testing; Time; Transportation; Treatment Cost; Treatment outcome; United States Dept. of Health and Human Services; Urine; Weight; Well in self; Work; abstracting; base; cocaine use; college; contingency management; cost; cost effectiveness; depressive symptoms; drug craving; fitness; flexibility; follow-up; improved; indexing; interdisciplinary approach; intervention effect; psychologic; psychological distress; sedentary; standard care; substance abuser; waist circumference

Abstract Physical activity has known positive effects with respect to improving health and reducing depression. While exercise also has some putative benefits for decreasing smoking, its effects on illicit drug use are relatively untested. Exercise may serve as a healthy substitute behavior for drug use. However, the majority of substance abusers are sedentary, and few individuals successfully initiate or maintain exercise regimens. Contingency management (CM) interventions are highly efficacious in reducing drug use, and growing evidence suggests these treatments can be adapted to alter a number of behaviors, including physical activity or exercise. We have pilot data suggesting that substance abusing patients who engage in exercise to earn reinforcement have improved drug abuse treatment outcomes compared to those who do not engage in exercise during CM treatments. Further, we have developed a CM-based exercise intervention, and our pilot data suggest that patients respond favorably to this intervention and begin exercising regularly. In this study, we plan to evaluate the efficacy of this exercise-based CM intervention. A total of 120 cocaine abusing patients in intensive outpatient treatment will be randomly assigned to one of two conditions: (a) standard care plus CM for completing goal-related activities not related to exercising (e.g., improving work, family, or transportation issues), or (b) standard care plus CM for completing exercise- related activities. Each intervention will consist of one weekly individual therapy session for 16 weeks, and patients in both conditions will earn the chance to win prizes for completing activities. All participants will provide urine and breath specimens 1-2 times weekly that will be tested for stimulants, opioids, marijuana and alcohol. Physical activity levels, drug use, psychological symptoms, and subjective and objective indicators of health (body mass index, waist circumference, blood pressure) will be measured pre-treatment and at months 2 and 4 (post-treatment), as well as at 6-,9- and 12-month follow-up evaluations. Compared to those receiving goal-related CM activity contracting, we expect that those in the exercise CM condition will participate in more physical activities and develop greater strength and flexibility, decrease drug use to a greater extent, reduce depressive symptoms, and improve health indices.

摘要 众所周知，体育锻炼对增进健康和减少肥胖有积极作用 抑郁症。虽然运动对减少吸烟也有一些公认的好处，但它对非法药物的影响 使用相对未经测试。锻炼可以作为药物使用的一种健康的替代行为。然而， 大多数药物滥用者都是久坐不动的，很少有人能成功地开始或保持锻炼 养生法。应急管理(CM)干预措施在减少药物使用方面非常有效， 越来越多的证据表明，这些治疗方法可以改变一些行为，包括 体力活动或锻炼我们有试点数据表明，滥用药物的患者 锻炼以获得强化与那些这样做的人相比，可以改善药物滥用治疗的结果 在中医治疗期间不从事运动。此外，我们还开发了一个基于CM的练习 干预，我们的试点数据表明，患者对这种干预反应良好，并开始 经常锻炼身体。 在这项研究中，我们计划评估这种基于运动的CM干预的效果。总共120个 门诊强化治疗中的可卡因滥用患者将被随机分配到两组中的一组 条件：(A)标准护理加上完成与锻炼无关的目标相关活动的CM(例如， 改善工作、家庭或交通问题)，或(B)标准护理加CM以完成锻炼- 相关活动。每一次干预将包括为期16周的每周一次的个人治疗，以及 这两种情况的患者都将有机会因完成活动而获得奖励。所有参与者将 每周提供1-2次尿液和呼气样本，以检测兴奋剂、阿片类药物和大麻 还有酒。体力活动水平、药物使用、心理症状、主观和客观 健康指标(体重指数、腰围、血压)将在治疗前测量 以及2个月和4个月(治疗后)，以及6个月、9个月和12个月的后续评估。相比较 对于那些接受与目标相关的CM活动合同的人，我们预计那些处于运动CM条件下的人 将参加更多的体育活动，培养更大的力量和灵活性，将药物使用减少到 在更大程度上，减轻抑郁症状，改善健康指数。