COMMUNITY/RELAPSE PEVENTION APPROACHS TO HEROIN ABUSE

拟议的研究旨在修改和测试的功效， 社区强化方法（CRA）在药物滥用人群。的 该研究的两个主要目的是测试CRA是否复发 预防技术，与标准治疗方案相比。CRA 由Nathan Azrin开发用于治疗酒精中毒， 在先前的结果研究中得到了显著的支持。找工作 俱乐部是CRA的一个组成部分，已为海洛因成瘾者进行了修改， 被证明是有效的。我们将修改CRA对海洛因的程序 并增加具体的技术，以减少早期辍学，改善 保持和减少复发的有害影响。双硫仑 CRA中使用的遵守程序将适用于海洛因成瘾者， 美沙酮有回家的特权 总之，拟议的研究将提供重要的新知识， 几个领域。(1)这将是CRA的第一个临床试验， 海洛因滥用人口(2)这将是世界上最大的 对药物滥用者进行任何治疗程序的试验。(3)将加大 对西班牙裔海洛因滥用患者的治疗知识， 允许西班牙裔和盎格鲁群体的比较，以及亚文化 分析。(4)它将提供确定概况所需的信息 对所研究的各种治疗的最佳反应者， 更复杂的方案来匹配病人和治疗方法。（六） 它将开发一种监测美沙酮依从性的独特方法 以减少非法美沙酮为目的， 转移注意力(7)最后，该研究将提供手动治疗， 可以很容易地传播和教授给其他治疗提供者。

The proposed study is designed to modify and test the efficacy of the Community Reinforcement Approach (CRA) in a drug abusing population. The two major aims of the study will be to test CRA with and without Relapse Prevention techniques, as compared to a standard treatment package. CRA was developed by Nathan Azrin for the treatment of alcoholism and has received significant support in prior outcome studies. The Job Finding Club, one component of CRA, has been modified for heroin addicts and has been shown to be effective. We will modify CRA procedures for heroin abusers and add specific techniques to reduce early drop out, improve retention and decrease the harmful effects of relapse. The disulfiram compliance procedure used in CRA will be applied to heroin addicts on methadone who have take home privileges. In summation, the proposed study will provide important new knowledge in several areas. (1) It will be the first clinical trial of the CRA with a heroin abusing population. (2) It will be one of the largest controlled trials of any treatment procedures for drug abusers. (3) It will increase knowledge of treatment for Hispanic heroin abusing patients and would permit comparisons of Hispanic and Anglo groups, as well as subcultural analyses. (4) It will provide information needed to determine the profiles of optimal responders to the various treatments studied, allowing progress toward more sophisticated schemes for matching patients to treatments. (6) It will develop a unique method for monitoring compliance with methadone take home doses, with the intended purpose of reducing illicit methadone diversion. (7) Finally, the study will provide manualized treatment that can be easily disseminated and taught to other treatment providers.