Korean Clinical Psychology Association
[ Review Article ]
Korean Journal of Clinical Psychology - Vol. 39, No. 2, pp.186-201
ISSN: 1229-0335 (Print) 2733-4538 (Online)
Print publication date 30 May 2020
Received 06 Feb 2020 Revised 09 Mar 2020 Accepted 10 Mar 2020
DOI: https://doi.org/10.15842/kjcp.2020.39.2.008

마약중독의 근거기반치료

김주은
충남대학교 심리학과
Evidence-Based Treatments of Drug Addiction
Jueun Kim
Department of Psychology, Chungnam National University, Daejeon

Correspondence to: Jueun Kim, Department of Psychology, Chungnam National University, 99 Daehkro(St), Yuseong-gu, Daejeon, Korea; E-mail: jueunkim@cnu.ac.kr.


© 2020 Korean Clinical Psychology Association

초록

한국에서의 불법 마약사용이 점점 더 심각한 문제로 대두되고 있기에, 마약중독 심리치료법에 대한 효과성을 검증할 필요가 있다. 이 연구의 목적은 국외와 국내의 근거기반 마약중독치료를 개관하는데 있다. 미국에서 시행된 메타분석 연구와, 한국에서 시행된 메타분석 연구가 없는 관계로 한국에서의 개별연구들을 개관하였다. 메타분석 연구들은 인지행동치료, 동기강화상담, 공동체 강화접근, 유관관리가 마약중독에 효과가 있다고 보고하고 있다. 효과성은 마약의 종류별로 상이한데, 대마사용장애에는 인지행동치료와 동기강화상담이, 자극제 사용장애에는 인지행동치료, 공동체 강화접근, 유관관리가 효과가 있는 것으로 나타났다. 국내에서는 주로 명상, 자기초월, 치료공동체 등의 문화적 특성을 고려한 프로그램이 시행되었다. 마지막으로 현재 연구들의 제한 점 및 앞으로의 연구들에 대한 권고를 제시하였다.

Abstract

Illegal drug addiction is more pervasive than has been recognized in Korea, and the efficacy of psychological treatments needs to be examined. The aim of this study was to review evidence-based treatments of drug addiction in the United States and Korea. Meta-analyses conducted in the United States and individual studies conducted in Korea (where a meta-analysis has not been conducted) were reviewed. The results of meta-analyses showed that cognitive behavior therapy (CBT), motivational interviewing (MI), community reinforcement approach (CRA), and contingency management (CM) were effective in treating drug addiction. The efficacy differed depending on the respective substances: CBT and MI were effective for cannabis use disorder, while CBT, CRA, and CM were effective for stimulant use disorder. In Korean studies, culture-bound and diverse programs, including meditation, self-transcendence, and therapeutic community programs, have been conducted. The limitations of the current studies and recommendations for future studies are discussed.

Keywords:

drug, addiction, evidence-based treatment

키워드:

마약, 중독, 근거기반치료

Acknowledgments

This work was supported by research fund of Chungnam National University.

References

  • Andrews, J., Guyatt, G., Oxman, A. D., Alderson, P., Dahm, P., Falck, Y., . . . Schünemann, H. J. (2013). GRADE guidelines: 14. Going from evidence to recommendations: The significance and presentation of recommendations. Journal of Clinical Epidemiology, 66, 719-725.. [https://doi.org/10.1016/j.jclinepi.2012.03.013]
  • Bao, Y., Liu, Z., Epstein, D. H., Du, C., Shi, J., & Lu, L. (2009). A meta-analysis of retention in methadone maintenance by dose and dosing strategy. American Journal of Drug & Alcohol Abuse, 35, 28-33.. [https://doi.org/10.1080/00952990802342899]
  • Benishek, L. A., Dugosh, K. L., Kirby, K. C., Matejkowski, J., Clements, N. T., Seymour, B. L., & Festinger, D. S. (2014). Prize-based contingency management for the treatment of substance abusers: A meta-analysis. Addiction, 109, 1426-1436.. [https://doi.org/10.1111/add.12589]
  • Carpenter, K. M., McDowell, D., Brooks, D. J., Cheng, W. Y., & Levin, F. R. (2009). A preliminary trial: Double-blind comparison of nefazodone, bupropion-SR, and placebo in the treatment of cannabis dependence. American Journal on Addictions, 18, 53-64.. [https://doi.org/10.1080/10550490802408936]
  • Carroll, K. M., Fenton, L. R., Ball, S. A., Nich, C., Frankforter, T. L., Shi, J., & Rounsaville, B. J. (2004). Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: A randomized placebo-controlled trial. Archives of General Psychiatry, 61, 264-272.. [https://doi.org/10.1001/archpsyc.61.3.264]
  • Carroll, K. M., Rounsaville, B. J., Nich, C., Gordon, L. T., Wirtz, P. W., & Gawin, F. (1994). One-year follow-up of psychotherapy and pharmacotherapy for cocaine dependence: Delayed emergence of psychotherapy effects. Archives of General Psychiatry, 51, 989-997.. [https://doi.org/10.1001/archpsyc.1994.03950120061010]
  • Chang, J. K. (2001). A study on effectiveness of the relapse prevention program for adult substances abusers. Journal of Korean Home Management Association, 19, 33-52..
  • Cho, J. H., & Son, C. N. (2013). Effects of the mindfulness-based cognitive therapy (MBCT) program on depression, impulsivity, and drug abstinence self-efficacy of drug addicts. Korean Journal of Clinical Psychology, 32, 13-31.. [https://doi.org/10.15842/kjcp.2013.32.1.002]
  • Cohen, J. (1994). The earth is round (p. 05). American Psychologist, 49, 997-1003.. [https://doi.org/10.1037/0003-066X.49.12.997]
  • Compton, D. R., Harris, L. S., Lichtman, A. H., & Martin, B. R. (1996). Marihuana. In C. R. Schuster & M. J. Kuhar (Eds.), Pharmacological aspects of drug dependence: Toward an integrated neurobehavioral approach (pp. 83-158). Berlin, Germany: Springer-Verlag. [https://doi.org/10.1007/978-3-642-60963-3_3]
  • De Crescenzo, F., Ciabattini, M., D’Alo, G. L., De Giorgi, R., Giovane, C. D., Cassar, C., . . . Cipriani, A. (2018). Comparative efficacy and acceptability of psychosocial interventions for individuals with cocaine and amphetamine addiction: A systematic review and network meta-analysis. PLoS Medicine, 15, e1002715.. [https://doi.org/10.1371/journal.pmed.1002715]
  • Davis, M. L., Powers, M. B., Handelsman, P., Medina, J. L., Zvolensky, M., & Smits, J. A. J. (2015). Behavioral therapies for treatment-seeking cannabis users: A meta-analysis of randomized controlled trials. Evaluation & The Health Professions, 38, 94-114.. [https://doi.org/10.1177/0163278714529970]
  • Dutra, L., Stathopoulou, G., Basden, S. L., Leyro, T. M., Powers, M. B., & Otto, M. W. (2008). A meta-analytic review of psychosocial interventions for substance use disorders. The American Journal of Psychiatry, 165, 179-187.. [https://doi.org/10.1176/appi.ajp.2007.06111851]
  • Fareed, A., Vayalapalli, S., Casarella, J., & Drexler, K. (2012). Effect of buprenorphine dose on treatment outcome. Journal of Addictive Diseases, 31, 8-18.. [https://doi.org/10.1080/10550887.2011.642758]
  • Finney, J. W., & Monahan, S. C. (1996). The cost-effectiveness of treatment for alcoholism: A second approximation. Journal of Studies on Alcohol, 57, 229-243.. [https://doi.org/10.15288/jsa.1996.57.229]
  • Gowing, L., Ali, R., & White, J. M. (2009). Buprenorphine for the management of opioid withdrawal. Cochrane Database of Systematic Reviews.. [https://doi.org/10.1002/14651858.CD002025.pub5]
  • Higgins, S. T., Budney, A. J., Bickel, W. K., Hughes, J. R., Foerg, F., & Badger, G. (1993). Achieving cocaine abstinence with a behavioral approach. American Journal of Psychiatry, 150, 763-769.. [https://doi.org/10.1176/ajp.150.5.763]
  • Higgins, S. T., Delaney, D. D., Budney, A. J., Bickel, W. K., Hughes, J. R., Foerg, F., & Fenwick, J. W. (1991). A behavioral approach to achieving initial cocaine abstinence. American Journal of Psychiatry, 148, 1218-1224.. [https://doi.org/10.1176/ajp.148.9.1218]
  • Hjorthoj, C. R., Baker, A., Fohlmann, A., & Nordentoft, M. (2014). Intervention efficacy in trials targeting cannabis use disorders in patients with comorbid psychosis systematic review and meta-analysis. Current Pharmaceutical Design, 20, 2205-2211.. [https://doi.org/10.2174/13816128113199990431]
  • Holder, H., Longabaugh, R., Miller, W., & Rubonis, A. (1991). The cost-effectiveness of treatment for alcoholism - A 1st approximation. Journal of Studies on Alcohol, 52, 517-540.. [https://doi.org/10.15288/jsa.1991.52.517]
  • Jones, R. T. (1980). Human effects: An overview. In R.C. Peterson (Ed.), National Institute of Drug Abuse Research Monograph No. 31 Marijuana Research Findings: 1980 (pp. 54-80). Washington, DC: U.S. Government Printing Office..
  • Kang, S., & Yoon, H. J. (2004). The Study on Effects of Rehabilitation Program for Substance Abusers in Prison. Korean Society for Correction Service, 21, 85-115..
  • Kim, K. H., & In, H. J. (2002). Effects of self-disclosure on negative emotion, physical symptoms, and attitudes toward drug for drug-abuser. The Korean Journal of Health Psychology, 7, 111-124..
  • Kim, Y., & Kim, S. (2017). Effects of the self-transcendence enhancement program among patients with drug addiction: A mixed method research. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 26, 1-13.. [https://doi.org/10.12934/jkpmhn.2017.26.1.1]
  • Kim, Y. J. (2000). A study on the effectiveness of short-term group activity pro for relapse prevention of substance abusers. Mental Health & Social Work, 9, 25-53..
  • Korea Correctional Office. (2019). [Internal data]. Investigation result of recidivism rate. (Ministry of Justice, Gwacheon). Retrieved from index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=2818.
  • Lee, M., Kim, D., & Choi, D. (2006). Effects of therapeutic recreation on self-esteem of adult substance abusers in the penitentiary. The Korean Journal of Physical Education, 45, 231-241..
  • Lee, Y. S., Cheon, S. M., & Kim, J. H. (2001). The effect of life skill training program for the drug abusing delinquent adolescents. The Korean Journal of Counseling and Psychotherapy, 13, 161-185..
  • Li, L., Zhu, S., Tse, N., Tse, S., & Wong, P. (2016). Effectiveness of motivational interviewing to reduce illicit drug use in adolescents: A systematic review and meta-analysis. Addiction, 111, 795-805.. [https://doi.org/10.1111/add.13285]
  • Ling, W., Hillhouse, M., Ang, A., Jenkins, J., & Fahey, J. (2013). Comparison of behavioral treatment conditions in buprenorphine maintenance. Addiction, 108, 1788-1798.. [https://doi.org/10.1111/add.12266]
  • Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2010). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 20, 137-160.. [https://doi.org/10.1177/1049731509347850]
  • Lussier, J. P., Heil, S. H., Mongeon, J. A., Badger, G. J., & Higgins, S. T. (2006). A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction, 101, 192-203.. [https://doi.org/10.1111/j.1360-0443.2006.01311.x]
  • Magill, M., & Ray, L. A. (2009). Cognitive-behavioral treatment with adult alcohol and illicit drug users: A meta-analysis of randomized controlled trials. Journal of Studies on Alcohol and Drugs, 70, 516-527.. [https://doi.org/10.15288/jsad.2009.70.516]
  • Mattick, R. P., Breen, C., Kimber, J., & Davoli, M. (2009). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews.. [https://doi.org/10.1002/14651858.CD002209.pub2]
  • McDonell, M. G., Srebnik, D., Angelo, F., McPherson, S., Lowe, J. M., Sugar, A., . . . Ries, R. K. (2013). Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness. American Journal of Psychiatry, 170, 94-101.. [https://doi.org/10.1176/appi.ajp.2012.11121831]
  • McRae-Clark, A. L., Carter, R. E., Killeen, T. K., Carpenter, M. J., Wahlquist, A. E., Simpson, S. A., & Brady, K. T. (2009). A placebo-controlled trial of buspirone for the treatment of marijuana dependence. Drug and Alcohol Dependence, 105, 132-138.. [https://doi.org/10.1016/j.drugalcdep.2009.06.022]
  • Meyers, R. J., & Smith, J. E. (1995). Clinical guide to alcohol treatment: The community reinforcement approach. New York, NY: Guilford Press..
  • Miller, W. R., Andrews, N. R., Wilbourne, P., & Bennett, M. E. (1998). A wealth of alternatives: Effective treatments for alcohol problems. In W. R. Miller & N. Heather (Eds.), Applied Clinical Psychology. Treating addictive behaviors, 203-216. New York, NY: Plenum Press.. [https://doi.org/10.1007/978-1-4899-1934-2_15]
  • Miller, W. R., Wilbourne, P. L., & Hettema, J. E. (2003) What works? A summary of alcohol treatment outcome research. In R. K. Hester & W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed., pp. 13-63). Boston, MA: Allyn & Bacon..
  • Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B., Burke, M., & Lewis, G. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: A systematic review. The Lancet, 370, 319-328.. [https://doi.org/10.1016/S0140-6736(07)61162-3]
  • Park, S. (2018). An analysis and estimate of socioeconomic costs of narcotics and hazardous chemicals. Police Science Institute, 32, 217-251.. [https://doi.org/10.35147/knpsi.2018.32.3.217]
  • Park, S., & Baik, M. (2019). A qualitative study on the hidden crime rate measurement of drug crimes. Korean Police Studies Review, 18, 151-170.. [https://doi.org/10.38084/2019.18.1.6]
  • Park, S. G. (2002). The development and effectiveness of a self-love program for the treatment of drug abusers. Korean Journal of Clinical Psychology, 21, 693-703..
  • Payne, J. (2008). The Queensland drug court: a recidivism study of the first 100 graduates (Research and Public Policy Series Report No. 83). Retrieved from https://pdfs.semanticscholar.org/3150/a9ce2a32d1a0309f3679e23be8f2f9c9fe5f.pdf.
  • Perez-Mana, C., Castells, X., Vidal, X., Casas, M., & Capella, D. (2011). Efficacy of indirect dopamine agonists for psychostimulant dependence: A systematic review and meta-analysis of randomized controlled trials. Journal of Substance Abuse Treatment, 40, 109-122.. [https://doi.org/10.1016/j.jsat.2010.08.012]
  • Prendergast, M. L., Podus, D., Chang, E., & Urada, D. (2002). The effectiveness of drug abuse treatment: A meta-analysis of comparison group studies. Drug and Alcohol Dependence, 67, 53-72.. [https://doi.org/10.1016/S0376-8716(02)00014-5]
  • Prendergast, M., Podus, D., Finney, J., Greenwell, L., & Roll, J. (2006). Contingency management for treatment of substance use disorders: A meta-analysis. Addiction, 101, 1546-1560.. [https://doi.org/10.1111/j.1360-0443.2006.01581.x]
  • Reif, S., George, P., Braude, L., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Residential treatment for individuals with substance use disorders: Assessing the evidence. Psychiatric Services, 65, 301-312.. [https://doi.org/10.1176/appi.ps.201300242]
  • Roll, J. M., Petry, N. M., Stitzer, M. L., Brecht, M. L., Peirce, J. M., McCann, M. J., . . . Kellogg, S. (2006). Contingency management for the treatment of methamphetamine use disorders. American Journal of Psychiatry, 163, 1993-1999.. [https://doi.org/10.1176/ajp.2006.163.11.1993]
  • Roozen, H. G., de Waart, R., & van der Kroft, P. (2010). Community reinforcement and family training: An effective option to engage treatment-resistant substance-abusing individuals in treatment. Addiction, 105, 1729-1738.. [https://doi.org/10.1111/j.1360-0443.2010.03016.x]
  • Sayegh, C. S., Huey, S. J., Zara, E. J., & Jhaveri, K. (2017). Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis. Psychology of Addictive Behaviors, 31, 403-414.. [https://doi.org/10.1037/adb0000277]
  • Smith, N. T. (2002). A review of the published literature into cannabis withdrawal symptoms in human users. Addiction, 97, 621-632.. [https://doi.org/10.1046/j.1360-0443.2002.00026.x]
  • Smout, M. F., Longo, M., Harrison, S., Minniti, R., Wickes, W., & White, J. M. (2010). Psychosocial treatment for methamphetamine use disorders: A preliminary randomized controlled trial of cognitive behavior therapy and acceptance and commitment therapy. Substance Abuse, 31, 98-107.. [https://doi.org/10.1080/08897071003641578]
  • Supreme Prosecutors’ Office. (2010). 2009 Drug Crime Report (Government Publications Registration No. 11-1280000-000045-10). Seoul: Prosecution Service. Retrieved from http://www.spo.go.kr/site/spo/ex/board/List.do?cbIdx=1204.
  • Supreme Prosecutors’ Office. (2019). 2018 Drug Crime Report (Government Publications Registration No. 11-1280000-000045-10). Seoul: Prosecution Service. Retrieved from http://www.spo.go.kr/site/spo/ex/board/List.do?cbIdx=1204.
  • The Korean Academic of Science and Technology (KAST). (2019). The current status of drug abuse and policies to solve the problems (The Korean Academy of Science and Technology Research Report 126). Daejeon: KAIST. Retrieved from https://kast.or.kr/kr/space/publication.php?bbs_data=aWR4PTE3MTk5JnN0YXJ0UGFnZT0wJmxpc3RObz0yODImdGFibGU9Y3NfYmJzX2RhdGEmY29kZT1tb2smc2VhcmNoX2l0ZW09JnNlYXJjaF9vcmRlcj0=||&bgu=view.
  • U.S. Department of Defense, Department of Veterans Affairs. (2015). VA/DOD clinical practice guideline for the management of substance use disorders (guideline version 3.0). Retrieved from https://www.healthquality.va.gov/guidelines/MH/sud/VADoDSUDCPGRevised22216.pdf.
  • Yoon, H. (2016). The effects of samatha meditation program for drug addicts on carving, self-esteem and drug abstinence self-efficacy. Bul Gyo Hak Bo, 75, 285-313.. [https://doi.org/10.18587/bh.2016.06.75.285]
  • Zgierska, A., Rabago, D., Chawla, N., Kushner, K., Koehler, R., & Marlatt, A. (2009). Mindfulness meditation for substance use disorders: A systematic review. Substance Abuse, 30, 266-294.. [https://doi.org/10.1080/08897070903250019]