METHADONE TREATMENT: BEHAVIORAL/PHARMACOLOGICAL VARIABLE

美沙酮治疗的参数可以系统地操作 从而确定它们对治疗结果的贡献。这 该提案将研究各种此类行为和药理学 美沙酮维持治疗和美沙酮 解毒这个项目的目的有三个方面。一是 评估应急管理程序， 美沙酮维持治疗病人的临床管理。二是因为 许多阿片类药物滥用者不愿意参加长期美沙酮治疗， 维护计划，我们建议检查各种参数， 流动美沙酮戒毒，以确定是否流动 戒毒可以是一种可行且有效的治疗替代方案。 最后，本研究所产生的技术和知识基础 将在当地、区域、国家和 国际基础，以进一步打击静脉注射毒品 滥用和艾滋病毒感染的传播。 有待评估的具体应急管理程序包括 加强药物免费尿液与带回家的特权，加强 参加技能培训班，并享有带回家的特权， 加强会议治疗计划的目标与带回家的特权。 美沙酮门诊脱毒的剂量和持续时间参数 将在不希望参加美沙酮的客户中进行检查 维持治疗。增加意外开支的额外好处 门诊戒毒期间的管理计划，也将是 评估。 这些研究将提供关于相对的重要信息。 美沙酮应急管理程序的有效性 治疗设置，以及一般效用和最佳参数， 流动美沙酮戒毒纳入研究设计的将 是多个结局指标，以便确定相对疗效沿着 不同的维度（如吸毒行为，就业状况， 精神状态，以及成瘾严重程度中的全球指数 索引）。长期随访也将包括在设计中， 确保全面了解 受试者的治疗后功能。这些数据将为 评估治疗的短暂和持久益处。

The parameters of methadone treatment may be systematically manipulated so as to determine their contributions to treatment outcome. This proposal will examine a variety of such behavioral and pharmacological parameters within the context of both methadone maintenance and methadone detoxification. The purpose of this project is three-fold. First, to evaluate contingency management procedures that could be utilized in the clinical management of methadone maintenance patients. Second, because many opiate abusers are unwilling to participate in a long-term methadone maintenance program, we propose to examine various parameters of ambulatory methadone detoxification, in order to determine if ambulatory detoxification can be a viable and efficacious treatment alternative. Finally, the technologies and knowledge-base resulting from this research will be rapidly disseminated on a local, regional, national, and international basis in order to further the battle against i.v. drug abuse and the spread of HIV infection. The specific contingency management procedures to be evaluated included reinforcing drug free urines with take-home privileges, reinforcing attending skills training classes with take-home privileges, and reinforcing meeting treatment plan objectives with take-home privileges. The dose and duration parameters of ambulatory methadone detoxification will be examined in clients who do not wish to participate in methadone maintenance treatment. The additional benefits of adding a contingency management program during ambulatory detoxification will, also, be evaluated. These studies will provide important information about the relative efficacy of contingency management procedures within the methadone treatment setting, and of the general utility and optimal parameters for ambulatory methadone detoxification. Included in the study designs will be multiple outcome measures so as to determine relative efficacy along different dimensions (e.g. drug use behaviors, employment status, psychiatric status, and global indices found in the Addiction Severity Index). An extended follow-up will also be included in the design of the detoxification protocols to ensure comprehensive information on subjects'post-treatment functioning. These data will provide for the evaluation of both the transient and the enduring benefits of treatment.