Western Michigan University, United States.
Western Michigan University, United States.
Drug Alcohol Depend. 2020 Nov 1;216:108307. doi: 10.1016/j.drugalcdep.2020.108307. Epub 2020 Sep 21.
Methamphetamine use continues to be an important public health problem. Contingency management is among the most effective interventions for reducing methamphetamine use. It has been more than ten years since the last systematic review of contingency management for methamphetamine use disorder. Since then, an additional ten randomized controlled trials and a variety of other studies have been completed. The present systematic review includes 27 studies. Several factors, most notably problem severity, appear to predict treatment outcome. However, the effectiveness of CM has been demonstrated in studies restricted to MSM, studies restricted to implementation in community programs, and in studies of the general population of methamphetamine users conducted in research treatment programs. There appear to be broad benefits of contingency management intervention, including greater drug abstinence, higher utilization of other treatments and medical services, and reductions in risky sexual behavior. Twenty of the twenty-one studies that reported abstinence outcomes showed an effect of contingency management on abstinence, and seven of the nine studies that reported sexual risk behavior outcomes showed an effect of contingency management in reducing risky sexual behavior. Taken together, recent evidence suggests strongly that outpatient programs that offer treatment for methamphetamine use disorder should prioritize adoption and implementation of contingency management intervention.
甲基苯丙胺的使用仍然是一个重要的公共卫生问题。 而行为契约管理是减少甲基苯丙胺使用最有效的干预措施之一。 距离上一次对甲基苯丙胺使用障碍的行为契约管理进行系统评价已经过去了十多年。 此后，又完成了另外十项随机对照试验和各种其他研究。 本次系统评价包括 27 项研究。 有几个因素，最明显的是问题的严重程度，似乎可以预测治疗结果。 然而，CM 的有效性已在以下研究中得到证实：仅限于男男性接触者的研究、仅限于在社区项目中实施的研究，以及在研究性治疗计划中对一般的甲基苯丙胺使用者进行的研究。 行为契约管理干预似乎具有广泛的益处，包括更高的药物戒断率、更多地利用其他治疗和医疗服务，以及减少危险的性行为。 21 项报告了戒断结果的研究中有 20 项表明行为契约管理对戒断有影响，9 项报告了性行为风险结果的研究中有 7 项表明行为契约管理在减少危险性行为方面有影响。 综上所述，最近的证据强烈表明，为治疗甲基苯丙胺使用障碍而提供治疗的门诊项目应优先采用和实施行为契约管理干预。
