对酒精成瘾美沙酮患者的行为治疗。

A behavioral treatment of alcoholic methadone patients.

作者信息

Liebson I A, Tommasello A, Bigelow G E

出版信息

Ann Intern Med. 1978 Sep;89(3):342-4. doi: 10.7326/0003-4819-89-3-342.

Abstract

Alcoholism is a frequent complication of methadone treatment and is one of the few behaviors found to correlate with methadone treatment failure. To eliminate drinking among severely alcoholic patients, we tested the efficacy of incorporating methadone into a behavioral contingency to reinforce disulfiram ingestion. Methadone was dispensed to alcoholic narcotic addicts contingent upon their ingesting disulfiram, and as a control patients were urged to take disulfiram but received methadone regardless of whether they took disulfiram. The results indicated that the reinforced disulfiram treatment was highly successful in controlling alcoholism. In addition, nonstatistically significant trends suggested that the reinforced disulfiram treatment resulted in a superior adjustment, as reflected in arrest rate, unemployment, and illicit drug use. There appeared to be no significant physiologic or behavioral adverse effects.

摘要

酒精中毒是美沙酮治疗的常见并发症，也是与美沙酮治疗失败相关的少数行为之一。为了消除重度酒精中毒患者的饮酒行为，我们测试了将美沙酮纳入行为应急措施以强化双硫仑摄入的效果。美沙酮仅在酒精成瘾的麻醉药品成瘾者摄入双硫仑时才发放，作为对照，敦促患者服用双硫仑，但无论他们是否服用双硫仑都给予美沙酮。结果表明，强化双硫仑治疗在控制酒精中毒方面非常成功。此外，非统计学显著趋势表明，强化双硫仑治疗导致了更好的适应情况，这在逮捕率、失业率和非法药物使用方面得到了体现。似乎没有明显的生理或行为不良反应。