EVALUATION OF TREATMENTS OF OPIOID AND COCAINE DEPENDENCE

本节继续研究药理学和行为学 药物滥用的治疗以及这两种形式之间的相互作用 治疗方法。 这些研究的主要目的是消除 减少可卡因中艾滋病毒传播的可能性- 和/或海洛因依赖患者。 几乎所有的研究对象 注射毒品，感染和传播艾滋病毒的风险很高 感染 物质的两种主要非药物治疗 虐待，应急管理和认知/行为治疗，是 正在评估中。 我们实验室的早期研究表明， 禁欲强化应急措施有效地产生了 在内陆地区， 城市，静脉注射，接受标准美沙酮的多种药物滥用者 维持治疗。 认知/行为咨询方法 我们实验室开发的药物滥用治疗方法正在 纳入行为应急管理计划， 增加由行为产生的禁欲持续时间 通过鼓励长期改变药物使用和其他 艾滋病毒危险行为。 这项研究正在进行中，大约有70个 计划招募200名患者。 在过去的一年里，我们已经完成了两个 临床试验 一项试验评估了应急组合 管理和药物治疗（美沙酮维持） 阿片类药物依赖的治疗 第二项研究评估了 应急管理，以加强减少毒品使用， 迈向完全戒毒的一步。 这些试验的数据 目前正在分析中。 应急管理继续显示 有望成为治疗药物滥用的有效方法。 未来研究 将努力解决如何最好地结合联合收割机这种治疗方法， 药物和其他心理治疗，以产生长期的 行为上的改变

The section continues to investigate pharmacological and behavioral treatments of substance abuse and interactions between these two forms of treatments. A primary objective of these studies is to eliminate drug use and decrease the probability of HIV transmission in cocaine- and/or heroin-dependent patients. Nearly all of the population studied inject drugs and are at high risk for contracting and spreading HIV infection. Two major non-pharmacological treatments of substance abuse, contingency management and cognitive/behavioral therapy, are under evaluation. Earlier research in our laboratory has shown that abstinence reinforcement contingencies are effective in producing significant periods of abstinence from cocaine and opiates in inner- city, intravenous, polydrug abusers receiving standard methadone maintenance treatment. A Cognitive/Behavioral counseling approach to substance abuse treatment developed in our laboratory is being integrated into the behavioral contingency management program to increase the duration of abstinence produced by the behavioral treatment alone by encouraging long-term changes in drug use and other HIV risk behaviors. The study is underway with approximately 70 of the planned 200 patients enrolled. In the past year we have completed two clinical trials. One trial evaluated the combination of contingency management and a pharmacological treatment (methadone maintenance) on treatment of opioid dependence. The second study evaluated the use of contingency management to reinforce decreases in drug use as an initial step toward complete abstinence from drug use. Data from these trials are currently being analyzed. Contingency management continues to show promise as an effective treatment for substance abuse. Future research efforts will address how best to combine this treatment approach with medications and other psychosocial treatments to produce long-term changes in behavior.