Manejo de contingencias para el tratamiento de la adicción a la cocaína en un contexto sanitario público

  1. Sánchez Hervás, Emilio
  2. Zacarés Romaguera, Francisco 1
  3. Secades Villa, Roberto 1
  4. García Rodríguez, Olaya 1
  5. García Fernández, Gloria 1
  6. Santonja Gómez, Francisco José
  1. 1 Universidad de Oviedo
    info

    Universidad de Oviedo

    Oviedo, España

    ROR https://ror.org/006gksa02

Journal:
Revista iberoamericana de psicología y salud

ISSN: 2171-2069

Year of publication: 2010

Volume: 1

Issue: 1

Pages: 17-27

Type: Article

DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista iberoamericana de psicología y salud

Abstract

The demand for treatment for cocaine dependence increased significantly in recent years, therefore, the development and dissemination of effective treatments for cocaine dependence is an important public health priority in Spain and in the rest of Europe. The aim of the present study was to explore the effectiveness of one of the programs that has obtained the best results in the United States: The Community Reinforcement Approach (CRA) plus vouchers for the treatment of cocaine addiction. Eighty-six patients seeking treatment at a public healthcare clinic were randomly assigned to one of three treatment conditions: CRA, CRA plus vouchers, or standard care. Retention rate at three months was 57.9% in the CRA group, 66.7% in the CRA plus vouchers group, and 53.3% in the standard treatment group. In the CRA group, 21.1% of the patients maintained continuous abstinence, compared to 44.4% of the CRA plus vouchers group and 16,7% of the standard group. These results support the effectiveness and the adaptability of CRA plus vouchers in a public setting in Spain. Further follow-up will be required to confirm the long-term maintenance of the results.

Bibliographic References

  • American Psychiatric Association (2002). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
  • American Psychiatric Associacion (2006). Practice guideline for the treatment of patients with substance use disorders (2nd ed.). Washington, DC: Author.
  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., y Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
  • Budney, A.J., y Higgins, S.T. (1998). Treating cocaine dependence: A community reinforcement approach. Rockville, MD: National Institute on Drug Abuse.
  • Derogatis, L. R., Lipman, R. S., y Covi, L. (1973). SCL-90: An outpatient psychiatric rating scale--preliminary report. Psychopharmacological Bulletin, 9, 13-28.
  • Dutra, L., Stathopoulou, G., Basden, S., Leyro, T., Powers, M., y Otto, M. (2008). A meta-analitic review of psichosocial interventiones for substance use disorders. American Journal of Psychiatry, 165, 179-187.
  • García-Rodríguez, O., Secades Villa, R., Álvarez, H., Río, A., Fernández-Hermida, J., Carballo, J., Errasti, J., y Al-Halabí, S. (2007). Efecto de los incentivos sobre la retención en un tratamiento ambulatorio para adictos a la cocaína. Psicothema, 19, 134-139.
  • García-Rodríguez, O., Secades-Villa, R., Higgins, S, Fernández-Hermida, J., Carballo, J.L., Errasti, J., y Al-Halabí, S. (2009).Effects of voucher-based intervention on abstinence and retention in an outpatient treatment for cocaine addiction: a randomized controlled trial. Experimental and Clinical Psychopharmacology 17, 131-138.
  • García-Rodríguez O, Secades-Villa R, Higgins ST, Fernández-Hermida JR., y Carballo J.L. (2008). Financing a voucher program for cocaine abusers through community donations in Spain. Journal of Applied Behaviour Analysis, 41, 623- 628.
  • Higgins S.T, Delaney D.D, Budney A. J, Bickel W.K, Hughes J.R, Foerg, F., y Fenwick, J.W. (1991). A behavioral approach to achieving initial cocaine abstinence. American Journal of Psychiatry, 148, 1218–24.
  • Higgins, S.T. Badger, G.J., y Budney, A.J. (2000). Initial abstinence and success in achieving longer term cocaine abstinence. Experimental and Clinical Psychopharmacology, 8, 377-386.
  • Higgins, S.T., Sigmon, S.C., Wong, C.J., Heil, S.H., Badger, G.J, Donham, R., Dantona, R.L., y Anthony, S. (2003). Community reinforcement therapy for cocainedependent outpatients. Archives of General Psychiatry, 60, 1043-52.
  • Higgins, S.T., Heil, S.H., Dantona, R., Donham, R., Matthews, M., y Badger, G.J. (2007). Effects of varying the monetary value of voucher-based incentives on abstinence achieved during and following treatment among cocaine-dependent outpatients. Addiction, 102, 271-81.
  • Knapp W.P., Soares B, Farrell M., y Silva de Lima M. (2007). Psychosocial interventions for cocaine and psychostimulant amphetamines related disorders. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD003023.
  • Kokkevi, A., y Hartgers, C. (1995). European adaptation of a multidimensional assessment instrument for drug and alcohol dependence. European Addiction Research, 1, 208-210.
  • Lussier, J.P., Heil, S.H., Mongeon, J.A., Badger, G.J., y Higgins, S.T. (2006). A metaanalysis of voucher-based reinforcement therapy for substance use disorders. Addiction, 101, 192–203.
  • McGovern, M. Fox, T., y Xie, H. (2004) A survey of clinical practices and readiness to adopt evidence-based practices: dissemination research in an addiction treatment system. Journal of Substance Abuse Treatment, 26, 305 -312.
  • National Institute for Clinical Excellence (2006). Clinical guideline, CG 51. Drug misuse. Psychological interventions. London: National Institute of Clinical Excellence.
  • National Institute on Drug Abuse (2009). Principles of drug addiction treatment (2nd ed.). Maryland, MD: U.S. Department of Health and Human Services.
  • Prendergast, M., Podus, D., Finney, J., Greenwell, L., y Roll, J. (2006). Contingency management for treatment of substance use disorders: A meta-analysis. Addiction, 101, 1546–1560.
  • Roozen, H., Boulogne, J., Van Tulder, M., Van de Brink, W., De Jong, C., y Kerkhof, J. (2004). A systematic review of the effectiveness of the community reinforcement approach in alcohol, cocaine and opioid addiction. Drug and Alcohol Dependence, 74, 1-13.
  • Secades-Villa, R. García-Rodríguez, O. Fernández-Hermida, J., y Carballo, J.L. (2007). El programa de reforzamiento comunitario más terapia de incentivo para el tratamiento de la adicción a la cocaína. Adicciones, 19, 51-57.
  • Secades-Villa, R., García-Rodríguez, O., Higgins, S.T, Fernández-Hermida, J.R., y Carballo, J.L. (2008). Community reinforcement approach plus vouchers for cocaine dependence in a community setting in Spain: Six-month outcomes. Journal of Substance Abuse Treatment, 34, 202-207.
  • Seltzer, M.L. (1971). The Michigan alcoholism screening test: The quest for a new diagnostic instrument. The American Journal of Psychiatry, 127, 1653-1658.
  • Shearer, J. (2007). Psychosocial approaches to psychostimulant dependence: A systematic review. Journal Substance Abuse Treatment, 32, 41-52.
Data source: Dialnet