Calhoun Cardiology Center, Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030-3944, USA.
J Am Acad Psychiatry Law. 2011;39(3):370-8.
Drug and alcohol abusers frequently have legal difficulties, and the legal system often provides negative reinforcement for substance abuse treatment. In contrast, contingency management (CM) treatments utilize positive reinforcement procedures to improve patient outcomes. This study evaluated whether substance-abusing patients with legal problems at treatment entry had differential outcomes, in general and in response to CM, compared with those without legal problems. Data from three randomized CM trials (n = 393) were used in an evaluation of main and interactive effects of legal status and treatment condition, with respect to retention and abstinence. Compared with patients without legal difficulties, those with legal problems remained in treatment for shorter durations and achieved shorter periods of abstinence. CM was positively and significantly associated with longer durations of abstinence, regardless of legal status. Results suggest that substance abusers with legal problems have generally poor outcomes, but that CM is effective regardless of the patient's legal status.
药物和酒精滥用者经常遇到法律问题，而法律系统往往对药物滥用治疗提供负面强化。相比之下， 随附事件管理（CM）治疗利用积极的强化程序来改善患者的结果。本研究评估了在治疗开始时具有法律问题的药物滥用患者与没有法律问题的患者相比，在一般情况下以及对 CM 的反应方面，是否具有不同的结果。使用来自三项随机 CM 试验的数据（n = 393），评估了法律地位和治疗条件的主要和交互作用，以及保留和禁欲方面的作用。与没有法律困难的患者相比，有法律问题的患者在治疗中的持续时间更短，禁欲时间更短。无论法律地位如何，CM 都与更长时间的禁欲显著相关。结果表明，有法律问题的药物滥用者通常预后不良，但 CM 是有效的，无论患者的法律地位如何。
