Kosten T R, Kleber H D
Am J Drug Alcohol Abuse. 1984;10(2):249-66. doi: 10.3109/00952998409002784.
The pharmacologic promise of naltrexone has not been matched by therapeutic usefulness. Plagued by difficulties in the induction period and very high dropout, the drug remains limited to a very small segment of the opiate-addited population. Some programs have managed, however, to substantially improve on these problems and such strategies will be discussed. The paper will look at the different problems raised during the high dropout periods of induction, the first month of stabilization, and the later stages of maintenance. It will then focus on methods to deal with these problems. Strategies examined will include among others individual and group counseling, family and couples' therapy, and contingency contracting. Strengths and weaknesses of each of these both from our own 7 years of experience and in the literature will be examined.
纳曲酮在药理学上的前景尚未在治疗效果上得到体现。由于诱导期困难重重且脱落率极高，该药物的应用仍局限于极小一部分阿片类成瘾人群。然而，一些项目已设法在很大程度上改善了这些问题，本文将探讨此类策略。本文将审视在诱导期、稳定期的第一个月以及维持期后期高脱落率期间出现的不同问题。然后将重点关注解决这些问题的方法。所研究的策略将包括个体和团体咨询、家庭及夫妻治疗以及权变契约等。将根据我们自身7年的经验以及文献来审视每一种策略的优缺点。
