Treatment of Cocaine Addiction with Integrative Meditation

用综合冥想治疗可卡因成瘾

• 批准号: 7807168
• 负责人: KEVIN W CHEN
• 金额: $ 18.56万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7807168
• 关键词: Abstinence; Accounting; Anxiety; Attention; Autonomic nervous system; Behavior; Behavior Therapy; Behavioral; Breathing; China; Chinese People; Chronic; Client; Clinical; Cocaine; Cocaine Dependence; Cocaine Users; Dropout; Drops; Drug usage; FDA approved; Frequencies; Future; Guided imagery; Intervention; Learning; Manuals; Measures; Mediator of activation protein; Medicine; Meditation; Mental Depression; Modality; Nondirective Therapy; Observational Study; Outcome Measure; Outpatients; Patients; Pharmaceutical Preparations; Pharmacologic Substance; Phase; Pilot Projects; Professional counselor; Public Health; Qi Gong; Randomized Controlled Trials; Recovery; Recruitment Activity; Relapse; Relaxation; Research; Risk Factors; Self Care; Self Efficacy; Severities; Solutions; Staging; Stress; Symptoms; Testing; Therapeutic Effect; Time; Toxicology; Training; Treatment outcome; Urine; Withdrawal; Withdrawal Symptom; addiction; alcohol and other drug; base; cocaine use; control trial; coping; cost effective; craving; design; effective therapy; experience; follow-up; heart rate variability; improved; indexing; meetings; mindfulness; mindfulness meditation; negative mood; pilot trial; prevent; primary outcome; psychologic; psychosocial; public health relevance; secondary outcome; sound; standard care; theories; therapy development; tool; treatment as usual

DESCRIPTION (provided by applicant): Cocaine addiction continues to be a major public health problem in the U.S. With no FDA- approved pharmaceutical therapy, treatment often relies on psychosocial interventions, known as behavior therapy. Despite some positive progress these psychosocial interventions have limited efficacy with problems like high dropout, untreated physical symptoms and high relapse rate. Our clinical experience and pilot studies suggest that Integrative Meditation (IM) from Chinese medicine may help clients engage in treatment, reduce cravings/ withdrawal symptoms, and increase treatment retention, which appear missed by a typical behavior therapy. IM is an adaptation or simplified form of mindfulness meditation. It may enhance existing therapies to help reduce withdrawal symptoms, increase treatment engagement, and prevent relapse through step-by-step therapist facilitation. This will be a brief Stage-1b therapy development study, based on a preliminary therapist manual and an observational study. The specific aims include: (1) To conduct a pilot randomized controlled trial of 66 outpatient cocaine users with 12 weekly facilitation meetings to assess feasibility of recruiting and retaining cocaine addicts, and to determine effect size of IM-augmented treatment in comparison with Non-directive therapy (NT) control, with both groups receiving standard treatment as usual (TAU), (2) To examine the changes in attention networks and negative mood as possible mediators of treatment outcomes between the two groups. Treatment outcomes will be assessed at baseline, week 4, 8 and 12, and at the follow-up 3 months after intervention. Primary outcomes include cocaine urine toxicology, number of weeks in treatment, and intensity of cocaine use. Secondary outcome measures include Addiction Severity Index (ASI) composite scores, use of alcohol and other drugs, heart rate variability, craving, depression, anxiety, and self-efficacy. Additional measures are proposed to aid in understanding possible underlying mechanisms of IM's effect on attention networks and the autonomic nervous system. A diverse team experienced in meditation and behavior therapy development is brought together to conduct the proposed R21 project, and prepare for a full therapy development study. PUBLIC HEALTH RELEVANCE: Given the fact that cocaine addiction continues to be a major public health problem in the U.S. without a sound solution, the proposed study will implement a brief Stage-I study of adding Integrative Meditation (IM) as a self-care component to the current outpatient treatment to improve treatment outcome for cocaine addiction. IM requires minimum therapist involvement and can serve as an adjunct to other existing treatment modalities. It may not only provide the needed treatment for physical and psychological symptoms during withdrawal or abstinence at the time when a patient needs it, but also quickly engage patients in the treatment and improve patients' self-efficacy and attention network that could help keep them away from relapse. Therefore, if the study verifies its efficacy and feasibility, IM may become an important cost- effective tool in the field of addiction treatment.

描述(申请人提供)：可卡因成瘾在美国仍然是一个主要的公共卫生问题。由于没有FDA批准的药物疗法，治疗通常依赖于心理社会干预，即众所周知的行为疗法。尽管取得了一些积极的进展，但这些心理社会干预措施在高辍学率、未得到治疗的身体症状和高复发率等问题上的效果有限。我们的临床经验和试点研究表明，中医的综合冥想(IM)可以帮助客户进行治疗，减少渴望/戒断症状，并增加治疗留存率，而这似乎是典型的行为疗法所遗漏的。IM是正念冥想的一种改编或简化形式。它可能会增强现有的治疗方法，以帮助减少戒断症状，增加治疗参与度，并通过逐步促进治疗师的促进来防止复发。这将是一项基于初步治疗师手册和观察性研究的简短的1b阶段治疗发展研究。具体目标包括：(1)对66名门诊可卡因吸毒者进行试点随机对照试验，每周举行12次促进会议，以评估招募和保留可卡因成瘾者的可行性，并确定IM强化治疗与非直接治疗(NT)对照的效果大小，两组均接受照常标准治疗(TAU)；(2)考察注意网络和负面情绪的变化作为两组治疗结果的可能中介。治疗结果将在基线、第4、8和12周以及干预后3个月的随访中进行评估。主要结果包括可卡因尿毒学、治疗周数和可卡因使用强度。次要结果测量包括成瘾严重指数(ASI)综合得分、酒精和其他药物的使用、心率变异性、渴望、抑郁、焦虑和自我效能。本文还提出了其他措施，以帮助理解IM对注意网络和自主神经系统影响的可能潜在机制。一个在冥想和行为疗法开发方面经验丰富的不同团队被聚集在一起，以实施拟议的R21项目，并为全面的治疗开发研究做准备。 公共卫生相关性：鉴于可卡因成瘾在美国仍然是一个主要的公共健康问题，没有完善的解决方案，拟议的研究将实施一项简短的第一阶段研究，将综合冥想(IM)作为自我护理的组成部分添加到目前的门诊治疗中，以改善可卡因成瘾的治疗结果。IM需要最低限度的治疗师参与，并可作为其他现有治疗方式的辅助手段。它不仅可以在患者需要的时候为戒断或戒断期间的身体和心理症状提供所需的治疗，还可以迅速吸引患者参与治疗，并改善患者的自我效能和注意力网络，以帮助他们避免复发。因此，如果研究验证其有效性和可行性，IM可能成为成瘾治疗领域的一种重要的高性价比工具。