Abstinence-contingent recovery housing and reinforcement-based treatment following opioid detoxification

作者：Tuten Michelle^*; DeFulio Anthony; Jones Hendree E; Stitzer Maxine

来源：Addiction, 2012, 107(5): 973-982.

DOI：10.1111/j.1360-0443.2011.03750.x

• Abstinence
• day treatment
• detoxification
• opioid
• reinforcement-based treatment
• recovery housing

Aims To conduct a randomized, controlled trial of abstinence-contingent recovery housing delivered with or without intensive day treatment among individuals exiting residential opioid detoxification. Setting Out-patient drug-free substance abuse treatment program in Baltimore, Maryland. Participants Patients (n = 243) who completed medication-assisted opioid detoxification. Measurements Primary outcome was drug abstinence (opioid-and cocaine-negative urine and no self-reported opioid or cocaine use in the previous 30 days). Secondary outcomes included abstinence at all time-points (1, 3 and 6 months), days in recovery housing and employment. Findings Overall rates of drug abstinence were 50% for RH + RBT, 37% for RH and 13% for UC (P < 0.001). At 6 months, RH + RBT participants remained more likely to meet abstinence criteria than UC participants (37% versus 20%, P = 0.016). Length of stay in recovery housing mediated abstinence outcomes andwas longer in RH + RBT (49.5 days) than in RH (32.2 days; P < 0.002). Conclusions Abstinence-contingent recovery housing improves abstinence in opioid-dependent adults following medication-assisted detoxification. The addition of intensive ` reinforcement-based treatment' behavioural counseling further improves treatment outcomes, in part by promoting longer recovery house stays.

• 出版日期2012-5