Department of Psychiatry and Behavioral Sciences, Addiction Treatment Services-BBRC, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Friends Research Institute, Baltimore, Maryland, USA.
Am J Addict. 2023 Nov;32(6):554-562. doi: 10.1111/ajad.13457. Epub 2023 Aug 8.
People receiving agonist treatment for opioid use disorder often have family or friends who do not use illicit substances and could be mobilized to support recovery efforts. The present study evaluates the feasibility and preliminary efficacy of a community support intervention (CSI) designed to increase drug-free social support and expand drug-free network support.
Participants receiving methadone treatment and using illicit drugs (n = 33) were randomly assigned to a weekly CSI or education group for 12 weeks. CSI participants attended the group with a drug-free family member or friend, and were scheduled to engage together in two community activities per week designed to meet drug-free people. Education participants attended a weekly education group and were given two weekly written homework sessions.
CSI groups were well attended. CSI participation was associated with reduced conflict with the family member or friend, and with increased engagement in self-help groups. No condition differences were observed in social network variables or urinalysis results, though four CSI participants (24%) compared to 0 education participants met criteria for substantial (>75%) reductions in drug use. Many eligible patients chose not to participate.
These findings suggest good implementation feasibility and acceptability, and low demand feasibility. Broader clinical implementation requires strategies to improve patient willingness to enlist available social support.
Mobilizing family and friends to provide social support for people engaged in active drug use is possible. More work is needed on how to leverage support to change existing networks.
接受阿片类药物使用障碍激动剂治疗的人通常有不使用非法物质的家人或朋友，可以动员他们支持康复工作。本研究评估了一种旨在增加无毒品社会支持和扩大无毒品网络支持的社区支持干预（CSI）的可行性和初步疗效。
接受美沙酮治疗且使用非法药物的参与者（n=33）被随机分配到每周一次的 CSI 或教育组，进行 12 周的治疗。CSI 参与者与无毒品的家庭成员或朋友一起参加小组活动，并按计划每周参加两次旨在与无毒品人士会面的社区活动。教育组参与者参加每周一次的教育小组，并每周完成两次书面作业。
CSI 组的参与度很高。CSI 参与与家庭成员或朋友之间的冲突减少以及参加自助小组的积极性增加有关。在社会网络变量或尿液分析结果方面，没有观察到条件差异，尽管 4 名 CSI 参与者（24%）与 0 名教育参与者相比，符合药物使用量大幅减少（>75%）的标准。许多符合条件的患者选择不参与。
这些发现表明，实施的可行性和可接受性良好，需求可行性较低。更广泛的临床实施需要策略来提高患者征募可用社会支持的意愿。
动员家人和朋友为积极吸毒的人提供社会支持是可行的。如何利用支持来改变现有的网络，还需要做更多的工作。
