Randomized trial of standard methadone treatment compared to initiating methadone without counseling: 12-month findings.
Randomized trial of standard methadone treatment compared to initiating methadone without counseling: 12-month findings.
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DOI：
10.1111/j.1360-0443.2011.03700.x
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发表时间：
2012-05
期刊：
影响因子：
--
通讯作者：
Jaffe JH
中科院分区：
文献类型：
--
作者：
Schwartz RP;Kelly SM;O'Grady KE;Gandhi D;Jaffe JH
本研究旨在确定12个月的中期美沙酮（IM；监督美沙酮治疗，仅在治疗的前4个月进行紧急咨询），标准美沙酮治疗（SM；常规咨询）和恢复美沙酮治疗（RM：常规咨询，病例量较小）的相对有效性。采用随机对照试验比较IM、SM和RM治疗。IM持续4个月后，参与者转移到SM。该研究是在美国马里兰州巴尔的摩的两个美沙酮治疗项目中进行的。该研究包括230名通过等候名单新入院的成年美沙酮患者。我们在基线、基线后4个月和12个月进行了成瘾严重程度指数和补充问卷调查。测量包括治疗的保留时间、自我报告的海洛因和可卡因使用天数、犯罪行为和逮捕，以及海洛因和可卡因代谢物的尿检。在12个月时，在意向治疗基础上，IM， SM和RM组的治疗保留率无显著差异（分别为60.6%，54.8%和37.8%）。三组的尿检阳性均较基线显著下降（分别为海洛因和可卡因代谢物的ps<0.001和0.003），但这些措施在x组时间内没有显著的相互作用。31%的样本报告在这一年中至少有一次被捕，但没有显著的组间效应。药物咨询服务的有限性不应成为向依赖海洛因的成年人提供有监督的美沙酮的障碍——至少在治疗的前4个月是这样。
This study aimed to determine the relative effectiveness of 12-months of Interim Methadone (IM; supervised methadone with emergency counseling only for the first 4 months of treatment), Standard Methadone treatment (SM; with routine counseling) and Restored Methadone treatment (RM: routine counseling with smaller caseloads). A randomized controlled trial was conducted comparing: IM, SM, and RM treatment. IM lasted for 4 months after which participants were transferred to SM. The study was conducted in two methadone treatment programs in Baltimore, MD, USA. The study included 230 adult methadone patients newly-admitted through waiting lists. We administered the Addiction Severity Index and a supplemental questionnaire at baseline, 4-, and 12-months post- baseline. Measurements included retention in treatment, self-reported days of heroin and cocaine use, criminal behavior and arrests, and urine tests for heroin and cocaine metabolites. At 12 months, on an intent-to-treat basis, there were no significant differences in retention in treatment among the IM, SM and RM groups (60.6%, 54.8% and 37.8%, respectively). Positive urine tests for the three groups declined significantly from baseline (ps<0.001 and 0.003, for heroin and cocaine metabolistes respectively) but there were no significant Group x Time interactions for these measures. Thirty-one percent of the sample reported at least one arrest during the year, but there were no significant between-group effects. Limited availability of drug counseling services should not be a barrier to providing supervised methadone to adults dependent on heroin - at least for the first 4 months of treatment.
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影响因子：
4.2
作者：
Schwartz, Robert P.;Jaffe, Jerome H.;O'Grady, Kevin E.
通讯作者：
O'Grady, Kevin E.
影响因子：
120.7
作者：
MCLELLAN, AT;ARNDT, IO;OBRIEN, CP
通讯作者：
OBRIEN, CP
影响因子：
105.7
作者：
FARRELL, M;WARD, J;STRANG, J
通讯作者：
STRANG, J
影响因子：
5.9
作者：
STITZER, ML;IGUCHI, MY;FELCH, LJ
通讯作者：
FELCH, LJ
影响因子：
2.8
作者：
Reisinger HS;Schwartz RP;Mitchell SG;Peterson JA;Kelly SM;O'Grady KE;Marrari EA;Brown BS;Agar MH
通讯作者：
Agar MH