Amass L, Bickel W K, Crean J P, Higgins S T, Badger G J
Department of Psychiatry, University of Vermont, Burlington 05401, USA.
J Subst Abuse Treat. 1996 Jan-Feb;13(1):43-9. doi: 10.1016/0740-5472(95)02060-8.
This study evaluated preferences for various clinic privileges, retail items, and social activities for use in an outpatient opioid dependence treatment program. Fifty-three opioid-dependent patients who received treatment with buprenorphine for at least 30 days rank ordered 11 clinic privileges, 19 retail items, and 8 social activities from the most desirable (a rank of 1) to the least desirable (a rank equal to the number of items in that category). Additional questions determined preference for counseling frequency and dosing levels. The top three mean rankings for clinic privileges were $50 cash for opioid-negative urines (2.8), take-home doses of buprenorphine (3.6), and voucher points for opioid-negative urines (4.7). The top three mean rankings for retail items were restaurant gift certificates (4.1), movie passes (4.9), and videotape movie and player rentals (6.8). The top three mean rankings for social activities were movies (2.4), barbecues (3.8), and hiking trips (4.3). There was no preference reported for increases or decreases in counseling frequency. Seventy-four percent of subjects preferred to increase their buprenorphine dose by an average of 60.84% independent of their present dose. Consistent with previous findings from methadone treatment, cash payments for opioid-negative urines and take-home medication were the highest ranked clinic privileges. These results suggest that various retail items and social activities may also be useful for reinforcing positive treatment outcomes during outpatient opioid treatment.
本研究评估了门诊阿片类药物依赖治疗项目中各种诊所特权、零售物品和社交活动的偏好情况。53名接受丁丙诺啡治疗至少30天的阿片类药物依赖患者,将11项诊所特权、19种零售物品和8项社交活动按照最期望(排名第1)到最不期望(排名等于该类别中的物品数量)进行了排序。另外的问题确定了对咨询频率和给药剂量水平的偏好。诊所特权的前三项平均排名为:阿片类药物阴性尿液检测呈阴性奖励50美元现金(2.8)、丁丙诺啡带回家剂量(3.6)以及阿片类药物阴性尿液检测呈阴性奖励代金券积分(4.7)。零售物品的前三项平均排名为:餐厅礼品券(4.1)、电影票(4.9)以及录像带电影和播放器租赁(6.8)。社交活动的前三项平均排名为:看电影(2.4)、烧烤(3.8)以及徒步旅行(4.3)。对于咨询频率的增加或减少没有报告偏好。74%的受试者倾向于将丁丙诺啡剂量平均增加60.84%,与他们目前的剂量无关。与美沙酮治疗的先前研究结果一致,阿片类药物阴性尿液检测呈阴性现金支付和带回家药物是排名最高的诊所特权。这些结果表明,各种零售物品和社交活动在门诊阿片类药物治疗期间也可能有助于强化积极的治疗效果。