METHADONE TREATMENT--BEHAVIORAL/PHARMACOLOGICAL VARIABLE

美沙酮治疗是最广泛和有效的治疗方法 因为鸦片成瘾因为阿片类药物使用者经常滥用药物以外的 阿片类药物，美沙酮治疗应包括干预措施，以减少非 使用阿片类药物可以使用治疗设置中的各种因素 来强化和改变行为。我们之前对偶然性的研究 管理程序已使用美沙酮的带回家剂量， 在加强禁欲方面取得了适度的成功。在这篇文章中，我们试图 为了提高治疗成功率， 多个行为和多个事件之间的应急协调 后果强化应急管理干预措施具有以下特点： l）整合多种方案后果的优点，2） 强化更小的行为单位，3）强化多个。适当的 行为，4）从治疗的第一天开始引入强化， 5）允许更个性化的治疗。三组之间 采用随机分配的受试者设计， 应急管理包（TOKEN组），以我们先前评估的 并成功应用了应急管理干预（TAKE-HOME 组）和无强化对照条件（对照组）。这些 三组代表强化剂量反应连续体。总的来说， 将招募310例受试者（每组100例，10例试验受试者）， 参加这个为期九个月的方案。TOKEN干预受试者是 预期具有上级治疗效果，因为我们整合了 许多行为成分与证明的功效，成为一个更 综合治疗包。强化钢筋检查 该计划还预计将提供深入了解的基本特点， 有效的应急管理和药物滥用治疗。多 结果测量将用于确定相对治疗效果 沿着许多方面，如自我报告和目标所示 指标，如尿液和呼吸分析。

Methadone treatment is the most widely available and effective treatment for opiate addiction. Because opiate users often abuse drugs other than opiates, methadone treatment should include interventions to reduce non- opioid drug use. A variety of factors in the treatment setting can be used to reinforce and modify behavior. Our previous research on contingency management procedures has used take-home doses of methadone and achieved modest success in reinforcing abstinence. In this continuation, we attempt to increase treatment success by using a token economy for flexible coordination of contingencies between multiple behaviors and multiple consequences. The enhanced contingency management intervention has the advantages of l) integrating multiple programmatic consequences, 2) reinforcing smaller units of behavior, 3) reinforcing multiple.appropriate behaviors, 4) introducing reinforcement from the first day of treatment, and 5) permitting more individualized treatment. A three group between subjects design with random assignment is used to compare the enhanced contingency management package (TOKEN group) to our previously assessed and successfully applied contingency management intervention (TAKE-HOME group) and to a no-reinforcement control condition (CONTROL group). These three groups represent a reinforcement dose response continuum. In all, 310 subjects (100 per group and 10 pilot subjects) will be recruited to participate in this nine-month protocol. TOKEN intervention subjects are expected to have superior treatment outcomes because we have integrated a number of behavioral components with demonstrated efficacy into a more comprehensive treatment package. Examination of the enhanced reinforcement program is also expected to provide insight into basic features of effective contingency management and drug abuse treatment. Multiple outcome measures will be used to determine relative treatment efficacy along a number of dimensions, as indicated by self-report and by objective indices, such as urine and breath analysis.