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复发预防认知行为模型对参与伊朗美沙酮维持治疗的阿片类药物依赖患者的有效性。

Effectiveness of Relapse Prevention Cognitive-Behavioral Model in Opioid-Dependent Patients Participating in the Methadone Maintenance Treatment in Iran.

作者信息

Pashaei Tahereh, Shojaeizadeh Davoud, Rahimi Foroushani Abbas, Ghazitabatabae Mahmoud, Moeeni Maryam, Rajati Fatemeh, M Razzaghi Emran

机构信息

Dept .of Public Health, School of Health, Kurdistan University of Medical Science, Sanandaj, Iran. ; Iranian National Center for Addiction Studies, Tehran University of Medical sciences, Tehran, Iran.

Dept. of Health education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran Iran.

出版信息

Iran J Public Health. 2013 Aug;42(8):896-902.

Abstract

BACKGROUND

To evaluate the effectiveness of a relapse prevention cognitive-behavioral model, based on Marlatt treatment approach, in Opioid-dependent patients participating in the Methadone Maintenance Treatment (MMT) in Iran.

METHODS

The study consisted of 92 individuals treated with methadone in Iranian National Center of Addiction Studies (INCAS). Participants were randomized into two groups: educational intervention group (N=46) and control group (N=46). The intervention was comprised of 10 weekly 90 minute sessions, done during a period of 2.5 months based on the most high risk situations determined using Inventory Drug Taking Situation instrument. Relapse was defined as not showing up for MMT, drug use for at least 5 continuous days, and a positive urinary morphine test.

RESULTS

While, only 36.4% of the intervention group relapsed into drug use, 63.6% of the control group relapsed. The result of the logistic regressions showed that the odd ratio of the variable of intervention program for the entire follow up period was 0.43 (P<0.01). Further, the odd ratio of this variable in one month, three months, and 195 days after the therapy were 0.48 (P<.03), 0.31 (P<.02), and 0.13 (P<.02) respectively that revealed that on average, the probability of relapse among individuals in the intervention group was lower than patients in control group.

CONCLUSION

Relapse prevention model based on Marlatt treatment approach has an effective role in decreasing relapse rate. This model can be introduced as a complementary therapy in patients treated with methadone maintenance.

摘要

背景

评估基于马尔拉特治疗方法的预防复发认知行为模型对参与伊朗美沙酮维持治疗(MMT)的阿片类药物依赖患者的有效性。

方法

该研究包括92名在伊朗国家成瘾研究中心(INCAS)接受美沙酮治疗的个体。参与者被随机分为两组:教育干预组(N = 46)和对照组(N = 46)。干预包括每周10次,每次90分钟的课程,在2.5个月的时间内进行,课程内容基于使用药物服用情况量表确定的最高风险情况。复发被定义为未参加美沙酮维持治疗、连续至少5天使用毒品以及尿吗啡检测呈阳性。

结果

干预组仅有36.4%的人复吸,而对照组的复吸率为63.6%。逻辑回归结果显示,整个随访期内干预项目变量的比值比为0.43(P < 0.01)。此外,该变量在治疗后1个月、3个月和195天的比值比分别为0.48(P <.03)、0.31(P <.02)和0.13(P <.02),这表明平均而言,干预组个体的复发概率低于对照组患者。

结论

基于马尔拉特治疗方法的预防复发模型在降低复发率方面具有有效作用。该模型可作为美沙酮维持治疗患者的辅助治疗方法引入。

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