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首页> 外文期刊>The journal of clinical psychiatry >A randomized trial of concurrent smoking-cessation and substance use disorder treatment in stimulant-dependent smokers
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A randomized trial of concurrent smoking-cessation and substance use disorder treatment in stimulant-dependent smokers

机译：兴奋剂依赖性吸烟者同时戒烟和药物滥用障碍治疗的随机试验

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Objective: To evaluate the impact of concurrent treatments for substance use disorder and nicotine-dependence for stimulant-dependent patients. Method: A randomized, 10-week trial with follow-up at 3 and 6 months after smoking quit date conducted at 12 substance use disorder treatment programs between February 2010 and July 2012. Adults meeting D5M-IV-TR criteria for cocaine and/or methamphetamine dependence and interested in quitting smoking were randomized to treatment as usual (n 271) or treatment as usual with smoking- cessation treatment (n 267). All participants received treatment as usual for substance use disorder treatment. Participants assigned to treatment as usual with concurrent smoking-cessation treatment received weekly individual smoking cessation counseling and extended- release bupropion (300 mg/d) during weeks 1 10. During post-quit treatment (weeks 4 10), participants assigned to treatment as usual with smoking-cessation treatment received a nicotine inhaler and contingency management for smoking abstinence. Weekly proportion of stimulant- abstinent participants during the treatment phase, as assessed by urine drug screens and self-report, was the primary outcome. Secondary measures included other substanceicotine use outcomes and treatment attendance. Results:There were no significant treatment effects on stimulant-use outcomes, as measured by the primary outcome and stimulant-free days, on drug-abstinence, oron attendance. Participants assigned to treatment as usual with smoking-cessation treatment, relative to those assigned to treatment as usual, had significantly better outcomes for drug-free days at 6 month follow up (X2i 4.09, P <.05), with a decrease in drug-free days from baseline of 1 .3°o in treatment as usual with smoking cessation treatment and of 7.6°o in treatment as usual. Participants receiving treatment as usual with smoking-cessation treatment, relative to those receiving treatment as usual, had significantly better outcomes on smoking point prevalence abstinence (25.5°o vs 2.2°o; X2i 44.69, P<.001;OR 18.2). Conclusions:These results suggest that providing smoking-cessation treatment tu illicit stimulant-dependent patients in outpatient substance use disorder treatment will not worsen, and may enhance, abstinence from nonnicotine substance use. Trial Registration: Clinica ITria ls.gov identifier: NCTO 1077024
机译：目的：评估同时使用药物对兴奋剂依赖患者的药物滥用和尼古丁依赖的影响。方法：2010年2月至2012年7月之间，在12项药物滥用障碍治疗计划中进行了为期10周的随机试验，在戒烟后3个月和6个月进行随访。成年人符合可卡因和/或D5M-IV-TR标准对甲基苯丙胺依赖和对戒烟感兴趣的患者被随机分为常规治疗（n = 271）或常规戒烟治疗（n = 267）。所有参与者照常接受药物滥用障碍治疗。参加常规治疗并同时进行戒烟治疗的参与者在第1-10周接受每周一次个体戒烟咨询和安非他酮缓释剂（300 mg / d）。戒烟后治疗期间（第4-10周），参加治疗的参与者为通常接受戒烟治疗的人要接受尼古丁吸入器和戒烟措施。主要结果是治疗阶段每周戒断兴奋剂的参与者（通过尿液筛查和自我报告评估）。次要措施包括其他物质/烟碱使用结果和治疗出勤率。结果：通过主要结果和无兴奋剂天数测量，对兴奋剂使用结局，戒毒量或出勤率没有明显的治疗效果。与接受常规戒烟治疗的参与者相比，接受常规戒烟治疗的参与者在6个月的随访中无毒品日的转归明显更好（X2i 4.09，P <.05），药物减少从基线开始的无烟天数为：常规戒烟治疗为1 .3°o，常规治疗为7.6°o。与通常接受戒烟治疗的参与者相比，接受常规戒烟治疗的参与者在戒烟流行率方面具有明显更好的结局（25.5°o比2.2°o; X2i 44.69，P <.001; OR 18.2）。结论：这些结果表明，在门诊药物滥用障碍治疗中为依赖兴奋剂的患者提供戒烟治疗不会使非尼古丁药物滥用戒烟恶化，并且可能会增强戒烟。试用注册：Clinica ITria ls.gov标识符：NCTO 1077024

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