Journal of substance abuse treatment
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J Subst Abuse Treat · Apr 2012
Randomized Controlled TrialBrief intervention for drug-abusing adolescents in a school setting: outcomes and mediating factors.
This randomized controlled trial evaluated the use of two brief intervention conditions for adolescents (aged 12-18 years) who have been identified in a school setting as abusing alcohol and other drugs. Adolescents and their parents (N = 315) were randomly assigned to receive either a two-session adolescent-only (BI-A), two-session adolescent and additional parent session (BI-AP), or assessment-only control condition (CON). Interventions were manually guided and delivered in a school setting by trained counselors. ⋯ In addition, youth receiving the BI-AP condition showed significantly better outcomes compared with the BI-A group on several variables. Problem-solving skills and use of additional counseling services mediated outcome. The value of a school-based brief intervention for students is discussed.
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J Subst Abuse Treat · Jan 2011
Randomized Controlled TrialOutpatient versus inpatient opioid detoxification: a randomized controlled trial.
Opioid detoxification is not an effective stand-alone treatment for heroin dependence but is nevertheless an essential step in the path to recovery. There has been relatively little previous controlled research on the impact of treatment setting on the likelihood of successful completion of detoxification. In this study, 68 opioid-dependent patients receiving community treatment (predominantly with methadone) and requesting detoxification were randomly assigned to an inpatient versus outpatient setting. ⋯ Only 11 (16%) participants were opioid-free at the 1-month follow-up and 8 at the 6-month follow-up, with no between-group difference. Inpatient and outpatient opioid detoxification settings were not significantly different in completion or follow-up abstinence rates, but aspects of the study design may have favored the outpatient setting. Future studies should test patient characteristics that predict better outcomes in each setting.
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J Subst Abuse Treat · Sep 2010
Randomized Controlled TrialAntidepressant treatment does not improve buprenorphine retention among opioid-dependent persons.
Our goal was to determine whether treatment of depressive symptoms with escitalopram during buprenorphine treatment for opioid dependence would improve treatment retention compared to placebo in a 12-week, randomized, double-blind trial. Treatment dropout was defined as missing seven consecutive buprenorphine dosing days. Participants were 76% male, 80% non-Hispanic Caucasian, and 64% heroin users. ⋯ Participants randomized to escitalopram also did not have a significantly lower likelihood of testing positive for either opiates or other drugs during follow-up. Depressive symptoms often resolved with buprenorphine treatment, and the immediate initiation of escitalopram does not improve treatment retention, depression outcomes, or illicit drug use. Clinicians should determine the need for antidepressant treatment later in buprenorphine care.
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J Subst Abuse Treat · Apr 2003
Randomized Controlled Trial Comparative Study Clinical TrialMethadone versus buprenorphine maintenance for the treatment of heroin-dependent outpatients.
The aim of this study was to assess the efficacy of methadone compared with buprenorphine maintenance therapy in heroin-dependent patients over a treatment period of 18 weeks. Subjects were randomized to receive either methadone or buprenorphine in a comparative double-blind study and consisted of 164 heroin-dependent male patients who met the DSM-IV criteria for heroin dependence and were seeking treatment. The 164 subjects included 41 patients in 1-mg, 41 patients in 3-mg, and 41 patients in 8-mg dosage group of buprenorphine, and also 41 patients in the 30-mg dosage group of methadone. ⋯ Retention in the 8-mg dose group was significantly better than in the 1-mg dose group (p=.00041) and in the 3-mg dose group (p=.045); other comparison (1 mg dose with 3 mg dose) was not significant. Methadone group was significantly better than 1mg buprenorphine dose group (p=.004), but was not significantly different from 3 mg buprenorphine dose group (p=.18) or 8 mg buprenorphine dose group (p=.49). The results support the efficacy of buprenorphine for outpatient treatment of heroin dependence and seem to indicate that the highest dose (8 mg) of buprenorphine was the best of the three doses of buprenorphine, and also support the superiority of 30 mg of methadone compared to 1 mg dose of buprenorphine for Iranian heroin-dependent patients to increase their retention in treatment.
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J Subst Abuse Treat · Dec 2002
Randomized Controlled Trial Clinical TrialKetamine psychotherapy for heroin addiction: immediate effects and two-year follow-up.
Seventy detoxified heroin-addicted patients were randomly assigned to one of two groups receiving ketamine psychotherapy (KPT) involving two different doses of ketamine. The patients of the experimental group received existentially oriented psychotherapy in combination with a hallucinogenic ("psychedelic") dose of ketamine (2.0 mg/kg im). The patients of the control group received the same psychotherapy combined with a low, non-hallucinogenic (non-psychedelic), dose of ketamine (0.2 mg/kg im). ⋯ The results of this double blind randomized clinical trial of KPT for heroin addiction showed that high dose (2.0 mg/kg) KPT elicits a full psychedelic experience in heroin addicts as assessed quantitatively by the Hallucinogen Rating Scale. On the other hand, low dose KPT (0.2 mg/kg) elicits "sub-psychedelic" experiences and functions as ketamine-facilitated guided imagery. High dose KPT produced a significantly greater rate of abstinence in heroin addicts within the first two years of follow-up, a greater and longer-lasting reduction in craving for heroin, as well as greater positive change in nonverbal unconscious emotional attitudes than did low dose KPT.