The Matrix model of outpatient stimulant abuse treatment: evidence of efficacy.
ABSTRACT The current study examined the effectiveness of Matrix outpatient stimulant treatment. We associated 146 subjects' in-treatment abstinence data, treatment lengths, and weekly treatment activities to their 6-month abstinence outcomes as part of an interim analysis of a NIDA treatment demonstration project. Results indicated that the pretreatment subject characteristics of ethnicity and drug of choice significantly associated with treatment outcome using Matrix model treatment. Findings also demonstrated a treatment dose/abstinence response such that those who received longer Matrix treatment episodes demonstrated better abstinence outcomes. Further, in-treatment abstinence status and treatment length significantly associated with drug use status at follow-up. This set of findings provides evidence for the value of Matrix treatment and allows for these outcome data to be compared with reports on recent psychosocial treatments for stimulant dependence. This study also provides direction for evaluating longer term effectiveness for these types of drug treatments.
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ABSTRACT: Bupropion is an antidepressant with stimulant properties, which inhibits the reuptake of dopamine (DA) and norepinepherine, and is purported to enhance DA neurotransmission. Bupropion is considered an appealing candidate medication for the treatment of methamphetamine dependence. The current laboratory study was set forth to assess the impact of bupropion treatment on the subjective effects produced by methamphetamine in the laboratory. We also assessed the effects of bupropion treatment on craving elicited by exposure to videotaped methamphetamine cues. A total of 26 participants were enrolled and 20 completed the entire study (n=10 placebo and n=10 bupropion, parallel groups design). Bupropion treatment was associated with reduced ratings of 'any drug effect' (p<0.02), and 'high' (p<0.02) following methamphetamine administration. There was also a significant bupropion-by-cue exposure interaction on General Craving Scale total score (p<0.002), and on the Behavioral Intention subscale (p<0.001). Overall, the data reveal that bupropion reduced acute methamphetamine-induced subjective effects and reduced cue-induced craving. Importantly, these data provide a rationale for the evaluation of bupropion in the treatment of methamphetamine dependence.Neuropsychopharmacology 07/2006; 31(7):1537-44. DOI:10.1038/sj.npp.1300979 · 7.83 Impact Factor
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ABSTRACT: This study examined six-month outcomes for 194 criminal justice clients exiting outpatient drug-free treatment and assigned to aftercare or standard treatment. It compared sub-samples of those achieving positive (n=111) and negative outcomes (n=59), as defined by drug and alcohol use and arrests. Psychological variables and attendance at religious services distinguished significantly between groups. Predictor variables developed from that comparison were employed in logistic regression analyses making use of the full sample. Aftercare was found to be particularly significant for reduction in drug use, with optimism/pessimism about one's future and religious observance also significant predictors for substance use.American Journal on Addictions 10/2004; 13(5):447-60. DOI:10.1080/10550490490512780 · 1.74 Impact Factor
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ABSTRACT: The current study modeled 12-month postrelease rearrest (recidivism) in terms of pretreatment risk factors (i.e., criminal history, criminal thinking,) and during-treatment engagement in a sample of 653 subjects admitted to four prison-based substance treatment programs. Structural equation modeling was used to test during-treatment engagement as a mediator variable in explaining the relationship between the pretreatment risk factors and recidivism. Results indicated that (a) a long history of criminal conduct correlated with criminal thinking, which in turn had a significant negative relationship with engagement in treatment; (b) the level of criminal involvement had a significant positive relationship with rearrest, whereas the level of criminal thinking did not influence being rearrested directly; (c) the relationship between criminal history and rearrest was partially mediated by criminal thinking and treatment engagement, whereas the relationship between criminal thinking and rearrest was fully mediated by treatment engagement. The findings suggest that it is important to design interventions targeting criminal thinking and monitor treatment engagement as an indicator of treatment performance. Clinical implications also include the importance of facilitating treatment engagement and the utility of conducting prognostic assessment to inform treatment.Journal of Offender Rehabilitation 11/2013; 52(8):544-564. DOI:10.1080/10509674.2013.840353