Vermont Center for Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, Vermont 05401, United States of America.
Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, United States of America.
J Subst Abuse Treat. 2021 May;124:108274. doi: 10.1016/j.jsat.2020.108274. Epub 2021 Jan 2.
Controlled studies provide little empirical evidence to inform clinical recommendations for the optimal duration (i.e., "dosage") of psychosocial treatment for substance use disorders (SUDs). The current study prospectively examined the relationships among treatment dosage, participant adherence to the treatment regimen, and treatment outcomes in a population of adults with stimulant use disorder (cocaine and/or methamphetamine). The study randomly assigned eighty-five participants to receive either 4 weeks or 16 weeks of standardized outpatient treatment. The treatment consisted of cognitive behavioral therapy (CBT) and content covered was identical for each condition; only the planned duration of participation differed. Although both groups reduced stimulant use over time, participants in the 16-week condition were significantly more likely than those in the 4-week condition to provide stimulantnegative urine specimens 26 and 52 weeks following randomization. Participant adherence to treatment correlated significantly with drug-use outcomes: we observed a greater likelihood of stimulant-negative urine tests among those who completed treatment, irrespective of group assignment. Both the number of sessions attended and the percentage of prescribed sessions attended were associated with reductions in stimulant-use frequency 26 and 52 weeks after admission.
对照研究几乎没有提供实证证据来为物质使用障碍（SUD）的最佳治疗时长（即“剂量”）提供临床建议。本研究前瞻性地检查了接受兴奋剂使用障碍（可卡因和/或甲基苯丙胺）的成年人人群中治疗剂量、参与者对治疗方案的坚持程度和治疗结果之间的关系。研究将 85 名参与者随机分配到接受 4 周或 16 周标准化门诊治疗。治疗包括认知行为疗法（CBT），每个条件涵盖的内容都相同；仅参与计划的持续时间不同。尽管两组参与者的兴奋剂使用都随时间减少，但在随机分组后 26 周和 52 周时，16 周组的参与者提供兴奋剂阴性尿液样本的可能性明显高于 4 周组。参与者对治疗的坚持与药物使用结果显著相关：我们观察到，无论分组如何，完成治疗的参与者尿液中兴奋剂检测呈阴性的可能性更大。治疗后 26 周和 52 周，参加的治疗次数和规定治疗次数的百分比与兴奋剂使用频率的降低相关。
