Roll John M, Petry Nancy M, Stitzer Maxine L, Brecht Mary L, Peirce Jessica M, McCann Michael J, Blaine Jack, MacDonald Marilyn, DiMaria Joan, Lucero Leroy, Kellogg Scott
David Geffen School of Medicine, UCLA, USA.
Am J Psychiatry. 2006 Nov;163(11):1993-9. doi: 10.1176/ajp.2006.163.11.1993.
Theory and some preliminary evidence suggest that contingency management may be an effective treatment strategy or adjunct to psychosocial treatment for methamphetamine use disorders. An experimentally rigorous investigation on the topic was provided by a large multisite trial conducted under the auspices of the Clinical Trials Network of the National Institute on Drug Abuse.
The authors report data on 113 participants who were diagnosed with methamphetamine abuse or dependence. They were randomly assigned to receive 12 weeks of either treatment as usual or treatment as usual plus contingency management. Urine samples were tested for illicit drugs, and breath samples were tested for alcohol. The reinforcers for drug-negative samples were plastic chips, some of which could be exchanged for prizes. The number of plastic chips drawn increased with each week of negative samples but was reset to one after a missed or positive sample.
The participants in both groups remained in treatment for equivalent times, but those receiving contingency management in addition to usual treatment submitted significantly more negative samples, and they were abstinent for a longer period of time (5 versus 3 weeks).
These results suggest that contingency management has promise as a component in treatment strategies for methamphetamine use disorder.
理论及一些初步证据表明，权变管理可能是治疗甲基苯丙胺使用障碍的一种有效治疗策略或心理社会治疗的辅助手段。美国国家药物滥用研究所临床试验网络主持开展的一项大型多地点试验，对该主题进行了严格的实验性调查。
作者报告了113名被诊断为甲基苯丙胺滥用或依赖的参与者的数据。他们被随机分配接受为期12周的常规治疗或常规治疗加权变管理。对尿液样本进行非法药物检测，对呼气样本进行酒精检测。对毒品检测呈阴性的样本的强化物是塑料筹码，其中一些可以用来兑换奖品。每周毒品检测呈阴性的样本数量增加，但错过检测或检测呈阳性后会重置为1个。
两组参与者接受治疗的时间相当，但除常规治疗外还接受权变管理的参与者提交的阴性样本明显更多，且他们戒断的时间更长（分别为5周和3周）。
这些结果表明，权变管理有望成为甲基苯丙胺使用障碍治疗策略的一个组成部分。
