Friends Research Institute, 1020 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
Drug Alcohol Depend. 2013 Mar 1;128(3):222-9. doi: 10.1016/j.drugalcdep.2012.08.027. Epub 2012 Sep 20.
Buprenorphine is increasingly being used in community-based treatment programs, but little is known about the optimal level of psychosocial counseling in these settings. The aim of this study was to compare the effectiveness of OP and IOP level counseling when provided as part of buprenorphine treatment for opioid-dependent African Americans.
Participants were African American men and women starting buprenorphine treatment at one of two community-based clinics (N=300). Participants were randomly assigned to OP or IOP. Measures at baseline, 3- and 6-month included the primary outcome of DSM-IV opioid and cocaine dependence criteria, as well as additional outcomes of illicit opioid and cocaine use (urine test and self-report), criminal activity, retention in treatment, Quality of Life, Addiction Severity Index composite scores, and HIV risk behaviors.
Participants assigned to OP received, on average, 3.67 (SD=1.30)h of counseling per active week in treatment. IOP participants received an average of 5.23 (SD=1.68)h of counseling per active week (less than the anticipated 9h per week of counseling). Both groups showed substantial improvement over a 6-month period on nearly all measures considered. There were no significant differences between groups in meeting diagnostic criteria for opioid (p=.67) or cocaine dependence (p=.63). There were no significant between group differences on any of the other outcomes. A secondary analysis restricting the sample to participants meeting DSM-IV criteria for baseline cocaine dependence also revealed no significant between-group differences (all ps>.05).
Buprenorphine patients receiving OP and IOP levels of care both show short-term improvements.
丁丙诺啡越来越多地被用于社区为基础的治疗项目，但对于这些环境下的最佳心理社会咨询水平知之甚少。本研究的目的是比较当作为丁丙诺啡治疗阿片类药物依赖的非裔美国人的一部分时，提供 OP 和 IOP 水平咨询的效果。
参与者是非裔美国男性和女性，他们在两家社区诊所之一开始丁丙诺啡治疗（N=300）。参与者被随机分配到 OP 或 IOP。基线、3 个月和 6 个月的测量包括 DSM-IV 阿片类药物和可卡因依赖标准的主要结果，以及其他非法阿片类药物和可卡因使用（尿液检测和自我报告）、犯罪活动、治疗保留、生活质量、成瘾严重程度指数综合评分和 HIV 风险行为的额外结果。
OP 组参与者在治疗期间平均每周接受 3.67（SD=1.30）小时的咨询。IOP 组参与者平均每周接受 5.23（SD=1.68）小时的咨询（少于每周 9 小时的预期咨询）。两组在 6 个月期间在几乎所有考虑的测量指标上都有显著改善。两组在符合阿片类药物（p=.67）或可卡因依赖（p=.63）的诊断标准方面没有显著差异。在其他任何结果上，两组之间也没有显著差异。对基线可卡因依赖符合 DSM-IV 标准的样本进行二次分析也没有发现组间差异（所有 p>.05）。
接受 OP 和 IOP 水平护理的丁丙诺啡患者都表现出短期改善。
