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对阿片类药物依赖的多药滥用者饮酒和药物使用情况的实时评估。

Real-time assessment of alcohol drinking and drug use in opioid-dependent polydrug users.

作者信息

Preston Kenzie L, Jobes Michelle L, Phillips Karran A, Epstein David H

机构信息

Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, USA.

出版信息

Behav Pharmacol. 2016 Oct;27(7):579-84. doi: 10.1097/FBP.0000000000000250.

Abstract

We investigated relationships between drinking, other drug use, and drug craving, using ecological momentary assessment (EMA), in a sample of polydrug users who were not heavy drinkers. In a prospective longitudinal cohort study, 114 heroin and cocaine users on methadone-maintenance treatment carried handheld electronic diaries during waking hours and were screened for drug and alcohol use for up to 25 weeks. Individuals who fulfilled the Diagnostic and Statistical Manual of Mental Disorders criteria for alcohol abuse or dependence were excluded. Participants responded to 2-5 random prompts per day to report on their moods, cravings, and activities and initiated entries when they used or acutely craved heroin or cocaine. Drinking alcohol was assessed in both types of entries. Breath alcohol was measured three times weekly. Participants reported drinking alcohol in 1.6% of random-prompt entries, 3.7% of event-contingent entries when craving cocaine and/or heroin, and 11.6% of event-contingent entries when using cocaine and/or heroin. Alcohol drinking was also associated with higher craving ratings and prestudy alcohol use. More drinking was detected by ambulatory self-report than by in-clinic breath testing. Even though we had screened out heavy drinkers from our sample of polydrug users, drinking was associated with heroin and cocaine craving and actual use.

摘要

我们在一个并非重度饮酒者的多药滥用者样本中,采用生态瞬时评估(EMA)方法,研究了饮酒、其他药物使用与药物渴求之间的关系。在一项前瞻性纵向队列研究中,114名接受美沙酮维持治疗的海洛因和可卡因使用者在清醒时间携带手持式电子日记,并接受长达25周的药物和酒精使用筛查。符合《精神障碍诊断与统计手册》中酒精滥用或依赖标准的个体被排除。参与者每天回应2至5次随机提示,报告他们的情绪、渴求及活动情况,并在使用或强烈渴求海洛因或可卡因时开始记录。在这两种记录中均对饮酒情况进行评估。每周测量三次呼气酒精含量。参与者在1.6%的随机提示记录、3.7%的在渴求可卡因和/或海洛因时的事件相关记录以及11.6%的在使用可卡因和/或海洛因时的事件相关记录中报告饮酒。饮酒还与更高的渴求评分以及研究前的酒精使用有关。通过动态自我报告检测到的饮酒情况比诊所内呼气检测更多。尽管我们从多药滥用者样本中排除了重度饮酒者,但饮酒仍与海洛因和可卡因渴求及实际使用有关。

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