Historique
Périodique
Abstinence reinforcement maintenance contingency and one-year follow-up
(Suivi à un an de patients en traitement de maintenance ayant bénéficié d'un renforcement de l'abstinence sous forme de gains, lors de la phase d'induction de la méthadone)
Auteur(s) :
K. L. PRESTON ;
A. UMBRICHT ;
D. H. EPSTEIN
Article en page(s) :
125-137
Refs biblio. :
45
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Anglais
Thésaurus mots-clés
METHADONE
;
TRAITEMENT DE MAINTENANCE
;
ABSTINENCE
;
SUIVI DU PATIENT
;
EFFICACITE
Note générale :
Drug and Alcohol Dependence, 2002, 67, (2), 125-137
Note de contenu :
graph. ; tabl.
Résumé :
ENGLISH :
Background: Relapse to drug use is often seen when contingencies designed to reduce drug use are discontinued. This paper reports on a stepdown maintenance contingency and 1-year follow-up in 110 patients who were maintained on methadone (50 or 70 mg/day) and who had completed a contingency management trial targeted to decreasing their opiate use. In the prior study (induction phase, 8 weeks) participants received vouchers for each opiate-negative urine screen or noncontingently. Methods: In this study (maintenance phase, 12 weeks), participants were rerandomized to receive vouchers and take-home methadone doses contingent on providing opiate-negative urine specimens (N=55) or noncontingently (N=55). Since participants had been rerandomized from induction-phase contingencies, most study data were analyzed as if from a 2 x 2 (induction x maintenance) design. Follow-up interviews were conducted at 3, 6, and 12 months after study participation. Results: Patients who received the maintenance contingency following an 8-week induction contingency had better outcomes than those who received noncontingent incentives in either the maintenance or induction phases of the trial. Good outcome at follow-up was predicted by enrollment in methadone maintenance after the study. Significantly more participants in the maintenance contingency group transferred directly to another methadone program. Conclusion: These findings support the therapeutic value of extending the duration of contingency management and long-term methadone maintenance. (Review's abstract.)
ENGLISH :
Background: Relapse to drug use is often seen when contingencies designed to reduce drug use are discontinued. This paper reports on a stepdown maintenance contingency and 1-year follow-up in 110 patients who were maintained on methadone (50 or 70 mg/day) and who had completed a contingency management trial targeted to decreasing their opiate use. In the prior study (induction phase, 8 weeks) participants received vouchers for each opiate-negative urine screen or noncontingently. Methods: In this study (maintenance phase, 12 weeks), participants were rerandomized to receive vouchers and take-home methadone doses contingent on providing opiate-negative urine specimens (N=55) or noncontingently (N=55). Since participants had been rerandomized from induction-phase contingencies, most study data were analyzed as if from a 2 x 2 (induction x maintenance) design. Follow-up interviews were conducted at 3, 6, and 12 months after study participation. Results: Patients who received the maintenance contingency following an 8-week induction contingency had better outcomes than those who received noncontingent incentives in either the maintenance or induction phases of the trial. Good outcome at follow-up was predicted by enrollment in methadone maintenance after the study. Significantly more participants in the maintenance contingency group transferred directly to another methadone program. Conclusion: These findings support the therapeutic value of extending the duration of contingency management and long-term methadone maintenance. (Review's abstract.)
Affiliation :
NIDA, 5500 Nathan Shock Drive, Baltimore, MD 21224
Etats-Unis. United States.
Etats-Unis. United States.
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