Division of Infectious Diseases, David Geffen School of Medicine at University of California, Los Angeles, USA.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Drug Alcohol Rev. 2020 Mar;39(3):216-222. doi: 10.1111/dar.13019. Epub 2019 Dec 21.
As South Africa, especially the Western Cape Province, faces an epidemic of methamphetamine use disorder, therapeutic approaches suited to the South African context are needed. This secondary analysis assessed retention and methamphetamine abstinence outcomes in response to an 8-week pilot contingency management (CM) intervention trial of neural correlates of methamphetamine abstinence, exploring sociodemographic and clinical differences between responders and non-responders.
Research participants provided thrice-weekly monitored urine samples, which were analysed by qualitative radioimmunoassay. The primary outcome for this analysis was therapeutic response, defined as abstinence from methamphetamine (≥23 of 24 possible methamphetamine-negative urine samples).
Data from 30 adults living in Cape Town, South Africa (34 ± 6.1 years of age, mean age ± SD, 21 men) were included. Sixty-three percent (12 men) were responders. In bivariate comparisons, baseline measurements showed fewer responders reported monthly household income ≥25 000+ South African Rand (ZAR; ~USD $1880; vs. ZAR < 25 000) than non-responders (15.8% vs. 63.6%; P = 0.007). Furthermore, responders had higher median years of education (12 vs. 10; Kruskal-Wallis χ = 4.25, DF = 1, P = 0.039) and lower median body mass index than non-responders (19 vs. 24; Kruskal-Wallis χ = 6.84, P = 0.008).
Therapeutic response in this study were comparable to those obtained with CM for methamphetamine use disorder in North America and Europe. Our findings suggest that CM may be a useful component of treatment strategies to boost retention and continuous abstinence from methamphetamine in Cape Town, South Africa. Larger efficacy studies are needed in this setting.
随着南非，特别是西开普省，面临着冰毒使用障碍的流行，需要寻找适合南非国情的治疗方法。本二次分析评估了对 8 周试点性条件管理（CM）干预试验中与冰毒戒断相关的神经相关性的反应，以探讨对冰毒戒断反应者和非反应者之间的社会人口学和临床差异。
研究参与者提供了三次/周的监测尿液样本，这些样本通过定性放射免疫分析法进行分析。本次分析的主要结果是治疗反应，定义为冰毒（≥24 个可能的冰毒阴性尿液样本中的 23 个）的戒断。
本研究共纳入 30 名居住在南非开普敦的成年人（34±6.1 岁，平均年龄±SD，21 名男性）。63%（12 名男性）为反应者。在双变量比较中，基线测量显示，报告月收入≥25,000 南非兰特（ZAR；~1880 美元）的反应者人数少于非反应者（15.8%比 63.6%；P=0.007）。此外，反应者的中位数受教育年限（12 年比 10 年；Kruskal-Wallis χ=4.25，DF=1，P=0.039）较高，且体重指数中位数低于非反应者（19 比 24；Kruskal-Wallis χ=6.84，P=0.008）。
本研究中的治疗反应与北美和欧洲的 CM 治疗冰毒使用障碍的反应相当。我们的发现表明，CM 可能是增强开普敦南非地区冰毒戒断保留率和持续戒断的治疗策略中的有用组成部分。在此背景下，需要进行更大规模的疗效研究。
