Psychosocial Division, Addiction Institute Mount Sinai (AIMS), Laboratory of Psychosocial Processes in Addiction, Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, New York.
College of Global Public Health, New York University, New York, New York.
J Stud Alcohol Drugs. 2020 Sep;81(5):664-672. doi: 10.15288/jsad.2020.81.664.
Mentorship for Addiction Problems (MAP) is a new behavioral treatment formalizing client-to-client mentorship relationships as an adjunct to standard outpatient substance use disorder treatment. We tested the preliminary efficacy of MAP in reducing substance use and associated barriers to successful treatment outcomes.
A total of 65 participants (17 later recovery participants [LRPs] and 48 early recovery participants [ERPs]) with substance use disorders were randomized to MAP + Treatment as Usual (TAU) or TAU alone. Within MAP, for each cohort, a pool of 4-5 mentors (LRPs) was formed and engaged in mentoring activities for 24 weeks until 12-13 mentees (ERPs), newly admitted, had participated in MAP for 12 weeks. Behavioral and biological measures were conducted at baseline, weekly, monthly, and termination for all participants and during the 12-week follow-up for ERPs.
Substance use declined across both conditions for ERPs (N = 48) during treatment, Weeks 0-12 (p = .001); however, on average, ERPs in the MAP intervention used significantly fewer days than controls during Treatment Weeks 1-12 (p = .013) and during Follow-Up Weeks 13-24 (p = .043). Addiction Severity Index alcohol and drug use scores increased in TAU and decreased in MAP during Follow-Up Weeks 13-24 for ERPs, alcohol: b = -0.08, SE = 0.03, t(47) = -2.97, p = .005; drug use: b = -0.02, SE = 0.01, t(47) = -2.36, p = .023. In addition, there was high patient interest in MAP and good fidelity to delivery of treatment.
MAP shows promise assisting in the reduction of substance use early in treatment when vulnerability and risk for relapse is high and has a positive impact on serious problems undercutting addiction treatment efficacy.
成瘾问题指导（MAP）是一种新的行为治疗方法，将客户之间的指导关系正式化，作为标准门诊药物使用障碍治疗的辅助手段。我们测试了 MAP 在减少物质使用和与成功治疗结果相关的障碍方面的初步疗效。
共有 65 名患有物质使用障碍的参与者（17 名后期康复参与者 [LRP] 和 48 名早期康复参与者 [ERP]）被随机分配到 MAP+常规治疗（TAU）或单独 TAU。在 MAP 中，对于每个队列，都会形成一个由 4-5 名导师（LRP）组成的小组，并进行 24 周的指导活动，直到新入院的 12-13 名学员（ERP）参加了 12 周的 MAP。所有参与者在基线、每周、每月和治疗结束时进行行为和生物学测量，并在 ERP 的 12 周随访期间进行测量。
在治疗过程中，ERP（N=48）的物质使用量在两个条件下都下降了，从第 0 周到第 12 周（p=0.001）；然而，平均而言，在治疗的第 1-12 周，MAP 干预组的 ERPs 使用的天数明显少于对照组（p=0.013），在随访的第 13-24 周（p=0.043）也是如此。在随访的第 13-24 周，ERP 的 TAU 中的成瘾严重程度指数酒精和药物使用评分增加，而 MAP 中的评分下降，酒精：b=-0.08，SE=0.03，t（47）=-2.97，p=0.005；药物使用：b=-0.02，SE=0.01，t（47）=-2.36，p=0.023。此外，患者对 MAP 非常感兴趣，并且对治疗的实施具有很好的一致性。
MAP 有望在治疗早期帮助减少物质使用，此时易感性和复发风险较高，并且对破坏成瘾治疗效果的严重问题有积极影响。
