European Addiction Research
Special Topic Section. Pharmacological Treatment of Addiction
Experiences with an Outpatient Relapse Program (Community Reinforcement Approach) Combined with Naltrexone in the Treatment of Opioid-Dependence: Effect on Addictive Behaviors and the Predictive Value of Psychiatric ComorbidityRoozen H.G. · Kerkhof A.J.F.M. · van den Brink W.Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, TheNetherlands
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Published online: March 24, 2003
Issue release date: April 2003
Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3
ISSN: 1022-6877 (Print)
eISSN: 1421-9891 (Online)
For additional information: https://www.karger.com/EAR
Abstract
Background: There is increasing interest in naltrexone, an opiate antagonist, in the treatment of opiate addicts. The effects of naltrexone are often compromised by a lack of compliance and drop-out. The effects of this compound are probably more favorable when combined with a psychosocial intervention such as the Community Reinforcement Approach (CRA). Aim: To explore the effects of a combination therapy (naltrexone plus CRA treatment) and the predictive value of sociodemographic and psychopathologic characteristics. Method: Using a before-and-after design, heroine addicts (n = 24) receiving a combined naltrexone plus CRA treatment are compared with a group (n = 20) on methadone maintenance therapy (reference group). Results: Over a period of 6 months, 58% (14/24) did not relapse, after 1 year at least 55% (12/22) still met the initial goal of continuous abstinence. At baseline, the treatment group and the reference group were similar on nearly all variables except for the number of times clients were arrested. Within the treatment group, a comparison was made between the continuous abstinent and those who relapsed into frequent opioid use. Differences were significant in the cluster-B personality disorders and in polydrug users. Conclusion: The combination of naltrexone plus intensive CRA in an outpatient setting appears to be promising. A high score on cluster-B and polydrug use is associated with relapse.
© 2003 S. Karger AG, Basel
Related Articles:
References
-
American Psychiatric Association: Practice Guidelines for the treatment of patients with substance use disorders: Alcohol, cocaine, opioids. Am J Psychiatry 1995;152(suppl 11):1–59.
-
Washton AM, Gold MS, Pottash AC: Successful use of naltrexone in addicted physicians and business executives. Adv Alcohol Subst Abuse 1984;4:89–96.
External Resources
-
Guiteirrez M, Ballesteros J, Gonzales-Oliveros R, et al: Retention rates in two naltrexone programs for heroin addicts in Vitoria, Spain. Eur Psychiatry 1995;10:183–188.
External Resources
-
Meyers RJ, Miller WR: A Community Reinforcement Approach to Addiction Treatment. Cambridge, Cambridge University Press, 2001.
-
Kranzler HR, Rounsaville BJ: Dual Diagnosis and Treatment – Substance Abuse and Comorbid Medical and Psychiatric Disorders. New York, Dekker, 1998.
- McLellan AT, Luborski L, Woody GE, Druley KA, O’Brien CP: Predicting response to drug and alcohol treatments: Role of psychiatric severity. Arch Gen Psychiatry 1983;40:620–625.
- Verheul R, Kranzler HR, Poling J, Tennen H, Ball S, Rounsaville BJ: Co-occurrence of axis I and axis II disorders in substance abusers. Acta Psychiatr Scand 2000;101:110–118.
- DeJong CAJ, van den Brink W, Harteveld FM, van der Wielen EG: Personality disorders in alcoholic and drug addicts. Compr Psychiatry 1993;34:87–94.
-
Roozen HG, Deden AL, Kerkhof AJFM, Vorsteveld JP, van den Brink W: Detoxication of opiate addiction and prevention of recurrence: Administration of naltrexone and cognitive behavior therapy (in Dutch). Ned Tijdschr Geneeskd 1997;141:2377–2380.
External Resources
-
Meyers RJ, Smith JE: Clinical Guide to Alcohol Treatment: The Community Reinforcement Approach. New York, Guilford Press, 1995.
- Derogatis LR, Lipman RS, Covi L: SCL-90: An outpatient rating scale – Preliminary report. Psychopharmacol Bull 1973;9:13–27.
-
Wilde GJ: Neurotische Labiliteit Gemeten volgens de Vragenlijstmethode, druk 2. Amsterdam, van Rossen, 1970.
-
Duijsens IJ, Eurelings-Bontekoe EHM, Diekstra RFW, Ouwersloot G: VKP Vragenlijst voor Kenmerken van de Persoonlijkheid. Voorlopige Handleiding. Lisse, Swets & Zeitlinger, 1993.
-
Luteijn F, Kooreman A: Handleiding Groninger Intelligentie Test, GIT. Schriftelijke verkorte vorm. Lisse, Swets & Zeitlinger, 1987.
-
Arrindell WA, Ettema JH: Dimensionele structuur, betrouwbaarheid en validiteit van de Nederlandse bewerking van de Symptom Checklist (SCL-90); gegevens gebaseerd op een fobische en een normale populatie. Ned Tijdschr Psychol 1981;36:77–108.
- Koeter MW: Validity of the GHQ and SCL anxiety and depression scales: A comparative study. J Affect Disord 1992;24:271–280.
-
Koeter MW, Ormel J, van den Brink W: SCL-90 total score as an index of severity of psychopathology. Ned Tijdschr Psychol 1988;43:381–391.
-
de Zeeuw J: Algemene psychodiagnostiek. I: Testmethoden, druk 6. Amsterdam, Swets & Zeitlinger, 1986.
-
World Health Organization: The International Personality Disorder Examination (IPDE): Version 1.1. Geneva, World Health Organization, Division of Mental Health, 1993.
-
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3 revised. Washington, American Psychiatric Press, 1987.
- Zimmerman M: Diagnosing personality disorders – A review of issues and research methods. Arch Gen Psychiatry 1994;51:225–245.
-
Verheul R: The Role of Diagnosing Personality Disorders in Substance Abuse Treatment: Prevalence, Diagnostic Validity, and Clinical Implications; dissertation. Amsterdam, Thesis Publishers, 1997.
Article / Publication Details
Published online: March 24, 2003
Issue release date: April 2003
Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3
ISSN: 1022-6877 (Print)
eISSN: 1421-9891 (Online)
For additional information: https://www.karger.com/EAR
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
