Science-Based Treatment for Opioid-Dependent Adolescents

对阿片类药物依赖青少年的科学治疗

• 批准号: 6953631
• 负责人: Lisa A. Marsch
• 金额: $ 47.43万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-29 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6953631
• 关键词: adolescence (12-20); behavior therapy; behavioral /social science research tag; buprenorphine; clinical research; clinical trials; combination therapy; drug abuse chemotherapy; drug addiction; drug administration rate /duration; drug withdrawal; human subject; human therapy evaluation; interview; naltrexone; opiate alkaloid; patient oriented research; questionnaires; reinforcer; sample collection

DESCRIPTION (provided by applicant): Adolescents are increasingly abusing and becoming dependent on heroin and other opioids. The number of emergency room visits related to heroin among 12-17 year olds rose almost 600%, and the self-reported prevalence of heroin use among this group more than doubled in the last decade. As a result of the increased availability of high-potency, low-cost heroin, many adolescents initiate heroin use by snorting it, however, many often then progress to injection of heroin. Despite the critical need to identify efficacious treatments for this population, virtually no research has been conducted to systematically characterize or evaluate treatment interventions for adolescent heroin and opioid abusers. We recently conducted the first controlled study funded by NIDA to systematically evaluate the efficacy of several pharmacotherapies as detoxification agents along with intensive behavioral interventions in the treatment of this population. The purpose of this proposal is to evaluate ways to further improve on the promising outcomes from our initial study via combined behavioral-buprenorphine treatment for opioid-dependent youth. The primary aim is to examine if improved treatment outcomes can be achieved if the duration of buprenorphine detoxification is lengthened (when the rate of decrease in buprenorphine dose is slower, withdrawal symptoms may be of reduced intensity and youth are provided with a greater opportunity to learn new skills and behaviors addressing how they might best discontinue their opiate use, prevent relapse, and meet treatment goals). A secondary aim is to examine if the provision of monetary voucher-based incentives contingent on consumption of the opioid antagonist, naltrexone, reduces rates of relapse to opiate use in adolescents post-detoxification compared to when no such incentives are provided. This analysis may provide critical empirical information regarding how to best prevent relapse to opioid use among opioid- dependent youth. Another secondary aim is to identify significant predictors of treatment outcome. We will thus conduct an exploratory evaluation of demographic, baseline drug use, psychological and other history variables that may predict successful treatment outcomes. This work may help inform the refinement of treatment interventions for various sub-populations of opioid-dependent youth. Outcome measures will include opiate and other drug abstinence, retention, opiate withdrawal symptoms, HIV risk behavior, family relationships, as well as a variety of other secondary outcome measures. We plan to collect these measures at intake, during treatment and at several post-treatment follow-up timepoints. Overall, this research will contribute new empirical information that will inform the development of effective treatment interventions for the largely unstudied and rapidly expanding population of opioid-dependent youth.

描述（由申请人提供）： 青少年越来越滥用，并依赖海洛因和其他阿片类药物。 12-17岁的年轻人中与海洛因相关的急诊室访问数量增长了近600％，在过去十年中，该组中海洛因使用的自我报道流行率增加了一倍以上。由于高功能，低成本海洛因的可用性增加，许多青少年通过not着海洛因的使用来吞噬海洛因，但是，许多青少年经常会进展为海洛因注射。尽管需要确定对该人群有效的治疗方法，但实际上尚未进行系统的特征或评估青少年海洛因和阿片类药物滥用者的治疗干预措施。最近，我们进行了由NIDA资助的第一项对照研究，以系统地评估几种药物疗法作为解毒剂的功效，并在治疗该人群的治疗中进行强化的行为干预措施。该提案的目的是评估通过对阿片类药物依赖性青年进行的行为 - 布丁肾处理的联合治疗，以进一步改善我们最初研究的有希望的结果。主要目的是检查如果延长丁丙诺啡解毒的持续时间是否可以提高治疗结果（当丁丙诺啡剂量的降低速度降低时，戒断症状的强度可能会降低，而年轻人可能会降低戒断症状，​​并提供更大的机会，可以最大程度地解决他们的掌控性，并以对待他们的对待，并实现对待的方法，并遇到相对范围，并满足其范围，并实现相对的对待，并实现了对待的效果，并以相对的方式实现了对待，并以良好的方式实现了对待的目标，并且可以实现对待的目标，并以相对的方式实现了对待的方法，并可以实现对待的效果。第二个目的是检查基于货币凭证的激励措施是否取决于阿片类药物拮抗剂Naltrexone的消费，降低了对青少年的复发率与未提供此类激励措施相比的鸦片使用率。该分析可能会提供有关如何最好地防止阿片类药物依赖性青年在阿片类药物中复发的关键经验信息。另一个次要目的是确定治疗结果的重要预测指标。因此，我们将对人口统计学，基线药物使用，心理和其他病史变量进行探索性评估，这些变量可能会预测成功的治疗结果。这项工作可能有助于为阿片类药物依赖性青年的各种亚种群提供治疗干预措施的完善。结果指标将包括阿片类药物和其他药物的禁欲，保留率，阿片戒断症状，​​艾滋病毒风险行为，家庭关系以及各种其他次要结果指标。我们计划在摄入量，治疗期间和处理后的几个随访时间点时收集这些措施。总体而言，这项研究将贡献新的经验信息，这将为大量未研究和迅速扩大的阿片类药物依赖性青年人口的有效治疗干预措施开发。