title: A comprehensive pharmacologic-psychosocial treatment program for HIV-seropositive cocaine- and opioid-dependent patients. Preliminary findings.
abstract: HIV-seropositive opioid-dependent patients maintained on an opiate-agonist who continue to use cocaine and to engage in other high-risk behaviors may benefit from enhanced treatment services; however, there is currently little data to guide the formulation of such services. We report on a preliminary study in which six HIV-seropositive opioid-and cocaine-dependent patients were provided a 12-week comprehensive pharmacologic/psychosocial treatment program developed specifically to meet the treatment needs of HIV-seropositive drug users. This program was comprised of buprenorphine (12 mg/day), bupropion (150 mg/day), and twice weekly manual-guided group therapy. Results showed significant decreases in intravenous cocaine use, cocaine craving, and symptoms of depression. A post-hoc comparison to outcomes of eight HIV-seropositive patients receiving standard methadone-maintenance found no improvements for patients receiving standard care. Controlled investigation of enhanced drug treatment programs for HIV-seropositive patients may be warranted.
authors.affiliation: Yale University School of Medicine, Substance Abuse Center, New Haven, CT 06519, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Avants
authors.forename: A
authors.initials: A
authors.lastname: Margolin
authors.forename: D
authors.initials: D
authors.lastname: DePhilippis
authors.forename: T R
authors.initials: TR
authors.lastname: Kosten
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002047:Buprenorphine / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D003042:Cocaine; D003863:Depression / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D012944:Social Support; D019966:Substance-Related Disorders / Q000150:complications / Q000188:drug therapy / Q000628:therapy*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D009292:Narcotic Antagonists; D009294:Narcotics; D016642:Bupropion; D002047:Buprenorphine; D003042:Cocaine; D008691:Methadone