Estudio clínico controlado, comparación y réplica de una intervención para abusadores de narcóticos en Delhi, India.

Resumen

The behaviour which is established in an extreme way, under the control of external agents, can be treated through behavioural-cognitive therapeutic procedures (Rotter. 1954: Ellis, 1962; Bandura, 1969; Kanfer, 1971: Mahoney, 1974: Kanfer and Grintm, 1980: Di Clemente & Prochaska, 1985, among others),being advisable,in some cases, its combination with pharmacotherapeutic coadjuvants (Dorabjee, J., Samson, L., Kaplan, Ch.D., & Wodak, A., 1994).The principle demostrated by the first authors, is mainly applicable to the treatment for abuse of inhaled, for oral use, and injecting drugs, and the effectiveness of its combination with pharmacotherapeutic technics exclusively, for injecting drug users (IDUs or EsDI in Spanish language), pretends to be demostrated in this present study.The addiction to psychoactive substances can be proposed as a model of conduct which is not only determined by stimulus from the environment,but that is also subjected to the individuals own control. Self-reflec­tion and self determination are qualities of the individual's that can play an important role in the procedures of the behaviour therapy. In this context, the therapeutic con­cept of behavioural self-control has an important meaning (Eeldhegc, 1977; Eeldhege. 1980). Self-control, self-help, self-regulation,and self-control therapy directed towards clients addicted to drugs, serve for achieving the objective of regulating the drug ingesting behaviour, in such a way that the frecuency and intensity of the problem­atic behaviour may significantly diminish. The study’s is being applied. It will take ad­vantage of an unpublished model of controlled study that combines three different procedures of self-control in order to treat those who abuse of psychoactive sub­stances (SPAs),and of the reply of a substitutive pharmacotherapeutic procedure for UsDI They are: a) technics that are based on different sections of the model of work proposed by Kanfer in 1971 (self-observation, self-commitment, self-evaluation, self­reinforcement and self-punishment): b) procedures of covcrant conditionings) meth­ods belonging to the cognitive therapy, conceived on Mahoney's sense; Ulrich & Ulrich’s social training (1973); and d) the substitutive therapy procedure for those who abuse of narcotics, by using Dorabjee, Samson, Kaplan & Wodak’s 1994 study (see Appendix A). 

Palabras clave:

Buprenorphine Behavior cognitive therapy Substitutepharma. pharmacoterapy Rehabilitation before betoxification

Citas

Bickel,W K., Stitzer. M. L., Liebson ,J.A. ,Jasinski. D.R. & Johnson. R.E. (1988). A clinical trial with buprenorphine: comparison with methadone in the detoxification of Heroin addicts. Clinical pharmacology and therapeutics, 43, pp. 72-78.

Bowersox, J.A. (1995). Buprenorphine may soon be heroin treatment option. NIDA notes, January/Febreuary p. 8.

Conran, A., Lewis, J. W & Mcfarlane, I.R. ( 1977). Antagonist and agosnist properties of buprenorphine, a new antinociceptive agent. British Journal of pharmacology, 60, pp. 537-545.

Jasinski, D. R .. Pevnick ..J. S. & Griffith, J.D. (1978). Human pharmacology and abuse potential of the analgesic buprenorphine. Archives of general psychiatry. 35.pp. 501-516.

Kaplan, C.D., Morival. M. & Bieleman. B. (1993). The camp approachee to drug detoxification. Reporte HQ/92/485002, Organización Mundial de la Salud.

Ling, W. Rawson, R.A. & Copmpton, M.A. (1994). Substitution pharmacotherapies for opiod addiction: from metadone to LAAM and buprenorphine. Journal of psychoactive drugs, 26, pp.12

Ministerio ele Salud, Escuela Nacional de Salud Mental. (1994). Consumo de sustancias Psicoactivas en Colombia. Santafé de Bogotá.

Panda, S. (1993). Comunicación personal. Consejo Indú de Investigaciones Médicas, Salt Lake. Cálcuta.

Reisinger, M. (1985). Buprenorphine as new treatment for heroin dependence. Drug & alcohol Dependence, 16, pp. 257- 262.

Sarkar, S., Das, N., Panda, S., Naik,TN., Sarkar, K., Sing, D. C., ReaJte, J.M. & Tripathy, S.P. ( 1993 ). Rapid spread of HIV amoung injecting drig users in north-eastern states of India. Bulletin on Narcotics. XLV, pp. 91- 105.

Susser, M. (1995). Editorial: The tribulations of trials-interventions in communities. American journal of public health, 85, pp. 156-158.

Westermeyer,J. & Soudaly, C. (1984). Les­ sons from a metadone treatment program in Laos, 1972-75, Drug and Alcohol Dependence. 13, pp. 89-106.