BEHAVIOR REDUCING DRUG ABUSE AND HIV SPREAD

艾滋病毒传播与药物滥用之间存在着一种流行病。 休斯敦（美国第四大城市）是艾滋病病例第四多的城市。 艾滋病病毒正在迅速传播。可卡因和海洛因的滥用 猖獗主要的治疗预防工作可以通过以下方式进行： 实施有效的治疗和增加治疗的可用性。 精神病学和行为学系的教职员工 德克萨斯大学健康科学中心提出了一系列 治疗示范研究。我们将研究联合行动， 药物干预和行为要求， 可卡因和海洛因滥用的治疗。药理学参数 美沙酮给药的最佳组合是 没有很好的定义。氟西汀（一种具有特殊前景的新型抗抑郁药） 将被用作可卡因治疗的辅助药物。行为技术 据报道，对诊所要求的操纵是有效的，但 没有被广泛接受。这些项目将展示 这些干预措施的明智组合的有效性。独立 变量将包括这些干预措施的明智组合。 自变量将包括治疗药物和所需剂量 出勤制度，应急增援，和 偏好/非偏好的结果。因变量包括： 心理/精神状态、性行为、药物渴求、 成瘾严重程度、医疗状况、药物尿液筛查、依从性，以及 艾滋病毒状况。小组和单一受试者设计将是互补的。这 方法将：（1）最大化结果的一般性，同时（2）允许 纳入（a）不符合分组设计要求的患者，（B） 很难治疗，但对他们来说， 治疗可以实现，和/或（c）谁需要（在数字超过我们的 在完成其他项目后继续治疗。 只有两个公共治疗来源（1在-，1门诊）， 休斯顿，都由我们部门控制。支持本申请 将把门诊人数从每月100人增加到250人。这 这一努力得到了休斯顿卫生部和警察局的大力支持。 部门、市长办公室、艾滋病毒筛查诊所和直接护理 提供商

An epidemic exists in the nexus of HIV transmission and drug abuse. Houston, (4th largest U.S. city) has the 4th largest number of AIDS cases and HIV is spreading rapidly. Abuse of both cocaine and heroin is rampant. A major treatment prevention effort can be undertaken by implementing effective treatment and increasing treatment availability. The faculty and staff of the Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, propose a series of treatment demonstration studies. We will examine the joint action of pharmacological interventions and behavioral requirements in the treatment of cocaine and heroin abuse. Pharmacological parameters of methadone administration are well understood by optimal combinations are not well defined. Fluoxetine (a new antidepressant with special promise) will be used as an adjunct in cocaine treatment. Behavioral techniques and manipulation of clinic requirements are reported effective, but do not have widespread acceptance. These projects will demonstrate the efficacy of the judicious combination of these interventions. Independent variables will include judicious combination of these interventions. Independent variables will include Therapeutic drug and dose, required attendance regimen, contingencies for reinforcement, and preferred/nonpreferred consequences. Dependent variables will include; psychological/Psychiatric status, sexual behavior, drug craving, addiction severity, medical status, drug urine screens, compliance, and HIV status. Group and Single-Subject Designs will be complementary. this approach will; (1) maximize generality of results while, (2) permitting inclusion of (a) patients not meeting group design requirements, (b) who are difficult to treat but for whom demonstrations of alternative treatments can be achieved, and/or (c) who require (in numbers beyond our resources) continued treatment after completing other projects. There are only two public treatment sources (1 in-,1 outpatient) in Houston, both controlled by our Department. Support of this application will increase our outpatient census from 100 to 250 patients/month. This effort is strongly supported by the houston Health Department, Police Department, Mayors Office, HIV screening clinics, and direct care providers.