Lecture 14

Lecture 14 - Lecture 14 Treatment & Review Key Concepts...

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Lecture 14 – Treatment & Review Key Concepts behavioral therapy for addiction (Higgins contingency management) medications for psychostimulant addiction baclofen (GABA B ) dopamine D2 antagonists (pimozide) dopamine D3 antagonists ( SB27701) partial dopamine agonists (aripiprazole) GVG (Gamma-vinyl GABA, vigabatrin)) cocaine vaccine midterm exam – discussion and review
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http://www.nida.nih.gov/PODAT /PODATIndex.html
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Manual can be downloaded from NIDA web site
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See Higgins et al (1994) paper posted on WebCT for details of study
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Higgins et al. - Principles of Treatment drug use and abstinence are readily detected (method = frequent urine screens with on-site testing and immediate results) drug abstinence in positively reinforced (method = contingency management with escalating point system for vouchers) drug use results in immediate loss of reinforcement the density of reinforcement derived from non-drug sources is increased to compete with the effects of drugs (method = increase drug-free prosocial activities, couples counseling, skills training)
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Standard Tx – 12 step orientation, group therapy, lectures, videos, requested to have a sponsor in a local 12-step group (11% abstinent at week 24) Behavioral Tx contingency management (CM) with vouchers for clean urines (initial 12 weeks only), couples counseling, social rewards (58% abstinent at week 24) At one year follow-up, 84% abstinent in CM vs 53% in standard tx % abstinent from cocaine % continuous abstinence
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Effects of disulfiram (Antabuse) treatment in cocaine + alcohol abusers. Disulfiram treatment was associated with a significant decrease in # of drinking days, # drinks per occasion and a decrease in cocaine positive urines
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Addiction 101: 193-203, 2006
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Exp Clin Psychopharmacol. 2009 Jun;17(3):131-8. Effects of voucher-based intervention on abstinence and retention in an
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Lecture 14 - Lecture 14 Treatment & Review Key Concepts...

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