Carroll K M, Nich C, Ball S A, McCance E, Frankforter T L, Rounsaville B J
Department of Psychiatry, Yale University School of Medicine, USA.
Addiction. 2000 Sep;95(9):1335-49. doi: 10.1046/j.1360-0443.2000.95913355.x.
To evaluate outcomes 1 year after cessation of treatment for cocaine- and alcohol-dependent individuals.
Randomized controlled trial.
Urban substance abuse treatment center.
Ninety-six of 122 subjects randomized to treatment.
One of five treatments delivered over 12 weeks. Cognitive-behavioral treatment (CBT) plus disulfiram; Twelve-Step facilitation (TSF) plus disulfiram; clinical management (CM) plus disulfiram; CBT without disulfiram; TSF without disulfiram.
Percentage of days of cocaine and alcohol use during follow-up, verified by urine toxicology screens and breathalyzer tests.
First, as a group, participants reported significant decreases in frequency of cocaine, but not alcohol, use after the end of treatment. Secondly, the main effects of disulfiram on cocaine and alcohol use were sustained during follow-up. Finally, initiation of abstinence for even brief periods of time within treatment was associated with significantly better outcome during follow-up.
These findings support the efficacy of disulfiram with this challenging population and suggest that comparatively brief treatments that facilitate the initiation of abstinence may have long-term benefits.
评估可卡因和酒精依赖个体停止治疗1年后的治疗效果。
随机对照试验。
城市药物滥用治疗中心。
122名随机接受治疗的受试者中有96名。
在12周内提供的五种治疗方法之一。认知行为疗法（CBT）加双硫仑；十二步促进法（TSF）加双硫仑；临床管理（CM）加双硫仑；不使用双硫仑的CBT；不使用双硫仑的TSF。
随访期间可卡因和酒精使用天数的百分比，通过尿液毒理学筛查和呼气酒精含量测试进行验证。
首先，作为一个群体，参与者报告在治疗结束后可卡因使用频率显著下降，但酒精使用频率未下降。其次，双硫仑对可卡因和酒精使用的主要影响在随访期间持续存在。最后，在治疗期间即使短暂开始禁欲也与随访期间显著更好的结果相关。
这些发现支持双硫仑对这一具有挑战性群体的疗效，并表明促进禁欲开始的相对短暂的治疗可能具有长期益处。
