taff of the Drug Detox Project at the Haight-Ashbury Free Clinic just finished a major research study. During 1991 and 1992, 183 stimulant abusers-- most of them "crack" smokers-- were enrolled in a double-blind study of imipramine. The notion was that imipramine, an antidepressant drug, would ease of "craving" of withdrawing clients, help them not use drugs, and keep them in treatment longer. Clients were followed up at 14 days, 28 days, 3 months, and 6 months after admission. Urine samples were taken at that time. The client group was divided equally into "high dose imipramine" (150 mg/day) and a "very low dose imipramine" (10 mg/day) groups. The idea was to see if the "high dose" group would do better in treatment. As it turned out, the clients generally couldn't tell which dosage level they were on.
There were two major findings: Clients on high-dose imipramine stayed in treatment significantly longer than those on very low dose, and the high-dose group were significantly more drug-free (as measured by urinalysis) at the 14-day and 28-day followups. However, the two groups were roughly equal in terms of drug use at the 3-month and 6-month followups, and also in terms of reported craving.
The Detox Project has a two-step strategy in treating cocaine abuse: "comfortable withdrawal" followed by "sustained abstinence". The Project's intention is to find medications that make withdrawal from cocaine more "comfortable". This, paired with medical care, counseling, and other support, is meant to keep clients in treatment long enough to socialize them into Twelve Step groups, therapy groups, or other supportive aftercare, whereby to support their recovery. It now appears that clients who use imipramine will indeed stay in treatment longer. Initially, it was thought that craving reduction was what enabled imipramine to keep clients in treatment. The data suggest that there is some other aspect of imipramine that is somehow making clients more "comfortable".
(printer friendly version)
 |
 |
 |
 |
| Title Index | Subject Index | New Essays | Search |
| ©2004–2010 by John Newmeyer |
|||