***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A multicenter prospect i ve open study was performed in order to compare the effectiveness of 2 modalities of individual dynamic psychotherapy  in a group of recently detoxified opioid dependent patients . Thirty four patients were assigned to receive either short-term dynamic psychotherapy ( ST ) or long-term dynamic psychotherapy ( LT ) ; both modalities were offered along with drug counselling . At the end of the treatment , the short term therapy group was followed up for 2 years , while the long term therapy group continued the follow up for one year , due to the different time span of the treatment approaches . Dropout rates for ST ( 47 % ) and LT ( 53 % ) patients were similar , and the re-entry rate for the ST group was superior ( 62.5 % vs. 28.5 % ) . Short term interventions appear to be at least as effective as long term interventions , and have the advantage of a high rate of program re-entry . Further studies conducted on larger sample s are needed Drug abuse counseling was enhanced by node-link mapping , a visual representation technique , and evaluated in a posttreatment follow-up study . Clients r and omly assigned to receive mapping counseling reported less criminal activity 12 months after treatment than did clients in the st and ard counseling condition . It was also found that among clients staying less than 6 months in treatment , those in the mapping group had fewer urine sample s that tested positive for opiates at follow-up . Thus , mapping-enhanced counseling may be especially beneficial for clients who leave treatment prematurely We evaluated 3-month outcomes for reinforcement-based intensive outpatient treatment ( RBT ) , a new relapse prevention behavior therapy for inner city opiate abusers . The therapy provides abstinence-contingent partial support of housing , food and recreational activities , abstinence-contingent access to social skills and job finding group therapy and non-contingent individual counseling , all in the context of a day treatment program . Heroin abusers ( n = 52 ) , contacted at a 3-day detoxification unit , were r and omly assigned to RBT ( n = 28 ) or referred to community treatment re sources ( n = 24 ) after a staff escort from the detoxification unit . For RBT patients , treatment began on the day of discharge ; 61 % received partial rent support in a recovery house based on the need for drug-free housing ; the remainder were eligible for partial support of utility payments where they lived . Abstinence-based contingencies were in effect for 1 month with three times per week counseling available for an additional 2 months . One month after detoxification , 61 % of RBT versus 17 % of referral patients were enrolled in outpatient treatment ( P < 0.01 ) ; RBT patients were significantly less likely than controls to have returned to any drug use ; and 50 % of RBT versus 21 % of controls reported 30 days of abstinence from heroin and cocaine with confirmatory negative urine ( P < 0.05 ) . RBT patients had significantly lower scores on the Beck Depression Inventory at 1 month ( M = 9.0 versus 17.6 for controls ; P < 0.05 ) and showed evidence of less alcohol use and higher rates of employment . These results establish the short-term efficacy for RBT and support continued development and evaluation of this new outpatient behavioral treatment OBJECTIVE The authors compared the efficacy of a multicomponent behavioral treatment and drug abuse counseling for cocaine-dependent individuals . METHOD The 38 patients were enrolled in outpatient treatment and were r and omly assigned to the two treatments . Counseling in the behavioral treatment was based on the community reinforcement approach , while the drug abuse counseling was based on the disease model of dependence and recovery . Patients in the behavioral , but not the drug counseling , treatment also received incentives contingent on su bmi tting cocaine-free urine specimens . RESULTS Of the 19 patients who received behavioral treatment , 58 % completed 24 weeks of treatment , versus 11 % of the patients who received counseling . In the behavioral treatment group 68 % and 42 % of the patients achieved at least 8 and 16 weeks of documented continuous cocaine abstinence , respectively , versus 11 % and 5 % in the drug abuse counseling group . CONCLUSIONS This multicomponent behavioral treatment appears to be an effective intervention for retaining out patients in treatment and establishing cocaine abstinence This study examines the efficacy of providing Enhanced Abbreviated or St and ard Inpatient treatment and Outpatient treatment to drug-abusing clients . The experiment r and omly assigned 412 clients to two therapeutic community programs  , which differed primarily in planned duration . This study addressed limitations of prior research , as it used r and om assignment of clients to treatment programs , achieved high follow-up rates and used objective measures of drug use and criminal history . Self-reports and objective measures of criminal activity and substance abuse were collected at pre- and posttreatment interviews . Completing the entire 12-month program ( inpatient and outpatient ) was more important than duration of inpatient program attended . Regardless of program , completers had substantial reductions in posttreatment drug abuse and arrests . A 12-month course of treatment including at least 6 months in a therapeutic community followed by outpatient treatment can produce marked reductions in drug abuse and crime among persons who complete both phases OBJECTIVE Previous research has suggested that support services supplementing methadone maintenance programs vary in their cost-effectiveness . This study examined the cost-effectiveness of varying levels of supplementary support services to determine whether the relative cost-effectiveness of alternative levels of support is sustained over time . METHOD A group of 100 methadone-maintained opiate users were r and omly assigned to three treatment groups receiving different levels of support services during a 24-week clinical trial . One group received methadone treatment with a minimum of counseling , the second received methadone plus more intensive counseling , and the third received methadone plus enhanced counseling , medical , and psychosocial services . The results at the end of the trial period have been published elsewhere . This article reports the results of an analysis at a 6-month follow-up . RESULTS The follow-up analysis reaffirmed the preliminary findings that the methadone plus counseling level provided the most cost-effective implementation of the treatment program . At 12 months , the annual cost per abstinent client was $ 16,485 , $ 9,804 , and $ 11,818 for the low , intermediate , and high levels of support , respectively . Abstinence rates were highest , but modestly so , for the group receiving the high-intensity , high-cost methadone with enhanced services intervention . CONCLUSIONS This study suggests that large amounts of support to methadone-maintained clients are not cost-effective , but it also demonstrates that moderate amounts of support are better than minimal amounts . As funding for these programs is reduced , these findings suggest a floor below which supplementary support should not fall During its first 20 years of existence a national Swedish methadone maintenance programme  received 174 heroin addicts . Programme policy , with a massive emphasis on vocational rehabilitation , and outcome data are described . In 75 % of the cases the subjects ab and oned their drug abuse behaviour and took up work while 25 % were expelled from the programme due to violation of rules . The stability of the programme was established by 14 yearly check-ups of the percentage working and study ing , which remained about 80 % . The tendency towards maturing out of addiction was low in Swedish heroin addicts ( 6 % ) as evidence d by a special study including a 6-year follow-up of 34 subjects fulfilling admission criteria . Half of this group received methadone , while the other half were r and omly assigned controls . The death rate among controls was at least 73 times the expected for the age group studied ( 20 - 24 years ) , while 81 % of those receiving methadone became free of drug abuse and vocationally rehabilitated . The control group also showed a high rate of drug abuse-related morbidity . Among 34 female heroin addicted prostitutes 71 % ab and oned drugs and street prostitution and took up regular work A controlled trial studied whether cue exposure prevented relapse in opiate addiction . Subjects were r and omly allocated to one of two inpatient treatment setting s : a drug dependence unit with a special 10 week program and 4 weeks in a behavioural/general treatment unit without such a program  . In each setting , following drug-withdrawal , subjects had either cue exposure for at least six sessions over 3 weeks , or a control condition . Subjects were followed up twice , at about 6 weeks and 6 months post-treatment . 186 subjects were r and omly allocated ; 69 were assessed post-detoxification , and of these 43 completed cue exposure or control treatments . Cue exposure and control subjects did not differ in cue reactivity . This was evaluated post-treatment for cue exposure subjects and at a comparable time point for controls . All groups showed a significant decrement in cue-elicited craving , withdrawal responses and negative mood .  Cue exposure and control subjects did not differ at either of the two follow up interviews Female substance abusers recruited from the community were r and omly assigned to receive 1 of 3 brief interventions that differentially targeted their personality and reasons for drug use . The 90-min interventions were : ( a ) a motivation-matched intervention involving personality-specific motivational and coping skills training , ( b ) a motivational control intervention involving a motivational film and a supportive discussion with a therapist , and ( c ) a motivation-mismatched intervention targeting a theoretically different personality profile . Assessment 6 months later ( N = 198 ) indicated that only the matched intervention proved to be more effective than the motivational control intervention in reducing frequency and severity of problematic alcohol and drug use and preventing use of multiple medical services . These findings indicate promise for a client-treatment matching strategy that focuses on personality-specific motives for substance abuse INTRODUCTION Retention in a Methadone Maintenance Treatment Program ( MMTP ) is predictive of abstaining from heroin and has other benefits . Many individuals leave treatment before they experience these positive outcomes . OBJECTIVE This research project targeted MMTP drop-outs with an intervention design ed to assist them in returning to drug treatment . METHODS Subjects who had left MMTP within the prior 12 months were r and omly assigned to intervention or comparison groups . The 3-month long intervention consisted of street outreach , cognitive behavioral groups , and individual counseling . Data were analyzed for 175 subjects who were out of treatment at baseline and who returned for a 6-month follow-up interview ( Intervention group , N=111 ; Comparison group , N=64 ) . RESULTS A total of 87 % of subjects assigned to the intervention condition participated in at least one component . Intervention subjects who attended two or more cognitive behavioral group sessions were more likely than those who attended 0 - 1 sessions or those in the comparison group to have returned to treatment during the 6 month follow up time period ( 72 vs. 53 vs. 50 % , respectively , P<0.05 , chi square test ) . CONCLUSION MMTP drop-outs need not be lost to the drug treatment system if special efforts are made to engage them in interventions developed to encourage treatment re-entry OBJECTIVE Because discharged methadone maintenance patients represent a population at particularly high public health risk , the authors studied such patients 1 year after their discharge from a methadone program .  METHOD The locations of 94 of 110 discharged patients were successfully determined 1 year after discharge . Nine ( 10 % ) of these patients had died , 37 ( 39 % ) were already reenrolled in treatment , and 7 ( 7 % ) did not require treatment . The 41 remaining subjects were r and omly assigned to either the enhanced outreach counseling condition ( N = 27 ) or a st and ard referral condition ( N = 14 ) . RESULTS Within 2 weeks following this intervention , 17 ( 63 % ) of the 27 patients in the enhanced outreach counseling program and one ( 7 % ) of the 14 patients not in the program had reenrolled in treatment . CONCLUSIONS These data suggest that enhanced outreach counseling may be an effective outreach strategy as well as a risk-reduction for discharged methadone maintenance patients Opiate addicts beginning a new treatment episode on a methadone maintenance program were offered r and om assignment to drug counseling alone or to counseling plus six months of either supportive-expressive psychotherapy or cognitive-behavioral psychotherapy . Sixty percent of patients meeting the study criteria expressed an interest and 60 % of these actually became engaged . One hundred ten subjects completed the study intake procedure and kept three or more appointments within the first six weeks of the project . Measures including st and ardized psychological tests , independent observer ratings , and continuous records of licit and illicit drug use were done at baseline and seven-month follow-up . All three treatment groups showed significant improvement , but patients receiving the additional psychotherapies showed improvement in more areas and to a greater degree than those who received counseling alone , and with less use of medication . More than a third of opiate addicts in our treatment program thus both were interested in professional psychotherapy and apparently benefitted from it . Certain administrative procedures appear necessary to maximize the chances that psychotherapy can be used effectively with drug-addicted patients AIMS To assess the effectiveness of a motivational interview among hospitalized psychiatric patients with comorbid substance use disorder in reducing alcohol and other drug ( AOD ) use . DESIGN Subjects were assigned r and omly to receive an individual motivational interview ( n=79 ) or a self-help booklet ( control condition ; n=81 ) . SETTING Subjects were volunteers recruited from a major public psychiatric hospital . PARTICIPANTS Subjects met abuse or dependence criteria on the structured clinical interview for diagnosis ( SCID ) for alco 
    Output:
    
The main findings were that both Enhanced Outreach Counselling and Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management had significantly better outcomes than st and ard therapy within treatment .
This was regarding relapse to opioid use , re-enrollment in treatment and retention in treatment .
At 1-month and 3- month follow up the effects of Reinforcement Based Intensive Outpatient Therapy were not sustained .
There was no further follow up of the Enhanced Outreach Counselling group .
The Alternative Program for MMTP Drop-outs and the behavioural therapies of Cue Exposure and Contingency Management alone were no better than the control ( st and ard ) therapy .
At present psychosocial treatments alone are not adequately proved treatment modalities or superior to any other type of treatment .