- 作者：Sheila M. ; Alessi ; ; ; salessi@uchc.edu ; Carla ; Rash ; Nancy M. ; Petry
- 关键词：Contingency management ; Pretreatment marijuana use ; During treatment marijuana use ; Outpatients ; Treatment outcomes
- 刊名：Drug and Alcohol Dependence
- 出版年：2011
- 出版时间：1 October 2011
- 年：2011
- 卷：118
- 期：1
- 页码：62-67
- 全文大小：277 K
Background
Marijuana use is common in patients seeking treatment for cocaine use. Nevertheless, few studies have examined effects of marijuana use on treatment outcomes in general, and even fewer with respect to contingency management (CM) treatment, which has been criticized for potentially increasing non-reinforced drug use.Methods
Data from three randomized clinical trials of CM versus standard treatment (ST) in cocaine-abusing patients were examined (; mlns="""">N = 393) to assess effects of pretreatment marijuana use on outcomes. Patients were divided into two groups: (1) no self-reported marijuana use (No Pre-M; mlns="""">n = 315) and (2) any self-reported marijuana use (Pre-M; mlns="""">n = 78) in the 30 days pretreatment.
Results
CM was especially efficacious in enhancing retention in Pre-M patients such that retention nearly doubled among Pre-M patients assigned to CM versus those assigned to ST. In contrast, CM exerted only modest benefits on retention in No Pre-M patients. Pretreatment marijuana use was not related to during-treatment abstinence from cocaine, opioids, and alcohol, or abstinence at a Month 9 follow-up. However, CM treatment and longest duration of abstinence achieved during treatment were significant predictors of Month 9 abstinence. Pre-M patients also evidenced more improvements in drug problems over time when randomized to CM.
Conclusions
CM was especially efficacious in facilitating retention and improving severity of drug-related problems in those who used marijuana in the month before initiating treatment.