Opioid-Dependent Adolescents: A Detoxification Study

阿片类药物依赖青少年：戒毒研究

基本信息

批准号：
6523362
负责人：
Lisa A. Marsch
金额：
$ 7.58万
依托单位：
UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-09-30 至 2004-08-31
项目状态：
已结题

项目摘要

DESCRIPTION: (provided by applicant) School-aged children and adolescents are increasingly abusing and becoming dependent on heroin and opioids. Heroin use by 12th graders has increased by over 100 percent since the beginning of this decade. Additionally, the mean age of first use of heroin in the United States decreased from 27 years in 1988 to 18 years in 1997. Most adolescents initiate heroin use by snorting it; however, many often then progress to injection of heroin. This trend of increased injection drug use by adolescent heroin users increases their risk of contracting and spreading hepatitis, HIV and other serious diseases. Despite the critical need to identify efficacious treatments for this population, substance abuse treatment research has largely focused on adults, and virtually no research has focused on the unique status of the opioid-dependent adolescent. The aim of this R03 proposal is to systematically evaluate the efficacy of several pharmacotherapies as detoxification agents along with intensive behavioral interventions in the treatment of the growing population of opioid-dependent adolescents. In particular, we propose to compare in opioid-dependent adolescents the efficacy of opiate detoxification with buprenorphine to clonidine. Both pharmacotherapies will be provided with a common behavioral contingency management intervention. The behavioral intervention will include 1) the demonstrably efficacious behavioral therapy employed by Azrin and colleagues in the treatment of adolescent substance abusers, 2) voucher-based contingency management interventions to primarily promote opioid abstinence and, to a lesser degree, to promote clinic attendance and the completion of assessments 3) an outreach component as employed in the CRA approach designed to increase non-drug sources of reinforcement. This study will be, to our knowledge, the first controlled study to evaluate the relative efficacy of buprenorphine and clonidine when combined with behavioral treatment of opioid-dependent adolescents. Outcome measures will include opiate and other drug abstinence, treatment retention, opiate withdrawal symptoms, HIV risk behavior, as well as a variety of other secondary outcome measures. We plan to collect these outcome measures at intake, during treatment and for 6 months post-treatment. Data from the long-term follow-up period of the study will provide information regarding the extent to which pharmacological-assisted detoxification procedures reduce opioid-use among opioid-dependent adolescents. Overall, this research will contribute new empirical information pertinent to developing effective treatment interventions for opioid-dependent youth. As the number of opioid-dependent adolescents continues to dramatically increase, identifying effective treatments to meet the unique needs of this population is critical.

描述：（由申请人提供）学龄儿童和青少年越来越多地遭受虐待并成为依赖海洛因和阿片类药物。 12 年级学生的海洛因使用量增加了自本世纪初以来，这一比例超过 100%。此外，平均年龄美国首次吸食海洛因的年数从 1988 年的 27 年下降到 1997 年 18 岁。大多数青少年通过吸食海洛因开始吸食海洛因；然而，许多人随后往往会注射海洛因。这种增加的趋势青少年海洛因吸毒者注射吸毒会增加他们的风险感染和传播肝炎、艾滋病毒和其他严重疾病。尽管迫切需要为这一人群找到有效的治疗方法，药物滥用治疗研究主要集中在成年人身上，而且实际上没有研究关注阿片类药物依赖者的独特地位青少年。该 R03 提案的目的是系统地评估几种药物疗法作为解毒剂的功效对不断增长的人口进行强化行为干预治疗阿片类药物依赖青少年。特别是，我们建议比较阿片类药物依赖青少年阿片类药物解毒的功效丁丙诺啡改为可乐定。两种药物疗法都将提供常见的行为应急管理干预。行为方面干预措施将包括 1) 明显有效的行为疗法阿兹林及其同事受雇治疗青少年物质问题滥用者，2) 基于凭证的应急管理干预措施，主要促进阿片类药物戒断，并在较小程度上提高诊所就诊率以及完成评估 3) 中采用的外展部分 CRA方法旨在增加非药物强化来源。这项研究据我们所知，这将是第一个评估相对丁丙诺啡和可乐定联合行为治疗的疗效阿片类药物依赖青少年。结果措施将包括鸦片剂和其他药物戒毒、治疗保留、阿片戒断症状、艾滋病毒风险行为以及各种其他次要结果指标。我们计划在摄入时、治疗期间和 6 个月内收集这些结果指标治疗后。研究长期随访期的数据将提供有关药物辅助程度的信息戒毒程序可减少阿片类药物依赖青少年的阿片类药物使用。总体而言，这项研究将提供有关的新的经验信息为阿片类药物依赖青少年制定有效的治疗干预措施。作为阿片类药物依赖青少年的数量继续急剧增加，确定有效的治疗方法来满足该人群的独特需求是批判的。