Integrative Self-Empowerment Therapy for Cocaine Addiction
Abstract
The proposed pilot study will introduce a new outpatient treatment-enhancing therapy called "Integrative Self-Empowerment Therapy" (ISET) for cocaine addiction. The pilot study will examine the feasibility and acceptance of ISET, and its possible benefits. ISET is an integrated therapy with three components - auricular acupressure, resonant-frequency breathing and Integrative Meditation - which are delivered in three stages.
Auricular acupressure is a therapy from traditional Chinese medicine (TCM). In auricular acupressure, subjects press on stimulators affixed on ear-acupoints to achieve a therapeutic effect similar to that of acupuncture. Integrative Meditation is an adaptation of TCM Qigong practice that includes relaxation, slow breathing work, guided imagery, and mindfulness training to bring about a tranquil state. Integrative Meditation appears particularly helpful in reducing the mood and sleep problems, irritability and difficulties with attention that occur during cocaine abstinence. Resonant-frequency breathing training has demonstrated therapeutic effects on many symptoms related to imbalance of the autonomic nervous system. In addition to their therapeutic effects in treating addiction-related symptoms, all three approaches have one thing in common: the patients perform the therapy or exercise themselves to achieve self-empowerment. Self reliance is the key component this study tries to bring to treatment.
This study will add ISET to the existent outpatient addiction treatment. The goal is to improve treatment outcomes for cocaine abusers through the following specific aims: (1) To explore the feasibility and acceptance of adding ISET to the regular outpatient addiction treatment program; (2) To examine the possibility of adding ISET to existent treatment for increased retention or decreased dropout in the clinics; (3) To examine the possible benefits of adding ISET components to the treatment in comparison with the treatment-as-usual group in terms of craving, anxiety, depression, self-efficacy, quality of sleep, and improvement of other physical conditions; (4) To investigate the effect of ISET on improving treatment outcomes at the end of 12 weeks of study and at 3-months follow-up among the participating drug abusers.
From our preliminary studies and clinical experience, ISET should be effective in both improving symptoms of cocaine withdrawal and prevention of relapse. Up to 70 cocaine abusers (N=35 in each group) will be recruited in this pilot study. The primary outcomes in treatment include cocaine urine toxicology, weeks in treatment and self-reported craving or withdrawal scores, both at the end of treatment and at the 3-month follow-up. Secondary outcome measures include Addiction Severity Index (ASI) composite scores, quality of sleep, depression, anxiety, heart rate variability (HRV), intensity of other drug use, attention network tests, and self-efficacy. A diverse and experienced team has been brought together to conduct the proposed pilot study, and to prepare for future NIH grants and larger clinical trials.
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