Abstract Objective: Almost all individuals in methadone treatment for opioid dependence smoke cigarettes, and half of people in methadone treatment have an opioid relapse within six months. Dialectical behavior therapy (DBT) skills training has shown promise for addressing substance use and a variety of health behaviors and conditions; however, it has never been evaluated for smoking cessation in any population. The objective of this study was to field test a DBT skills training–based intervention for tobacco dependence and opioid relapse prevention (DBT-Quit) among people in methadone treatment. Methods: We recruited seven individuals in methadone treatment to participate in a field test of DBT-Quit. Participants attended 12 weekly 90-minute DBT skills training groups, focusing on mindfulness, emotion regulation, and distress tolerance skills. Participants received nicotine patches for eight weeks and completed assessments at baseline, 6 weeks (mid-treatment), and 12 weeks (post-treatment). Results: All but one participant (86%, n = 6) attended at least 50% of intervention sessions. Participants were “very” or “mostly” satisfied with the intervention. At 12 weeks, all but one (86%, n = 6) had made a quit attempt, and one (14%) had seven-day point prevalence abstinence. Participants were smoke-free for 24 hours (14%, n = 1), 7 to 14 days (43%, n = 3), and 30 to 59 days (29%, n = 2). Participants smoked significantly fewer cigarettes per day at 6 weeks and 12 weeks as compared to baseline. No participants used illicit drugs. As compared to baseline, at follow-up there were no significant differences in difficulties with emotion regulation, distress tolerance, or mindfulness. Conclusions: A DBT skills training–based intervention for individuals who smoke and have an opioid use disorder is feasible and acceptable in methadone treatment and may help this population prevent drug relapse, attempt to quit smoking, experience smoke-free days, and cut down on their smoking. More research is needed to determine the optimal structure and components of a DBT skills–based intervention for drug relapse prevention and smoking cessation. Further, a randomized controlled trial of DBT-Quit is needed to determine the efficacy of DBT skills training for smoking cessation and drug relapse prevention in this population.

中文翻译：

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基于辩证行为治疗技能培训的戒烟干预和预防美沙酮治疗中阿片类药物复发的现场试验

摘要 目的：几乎所有接受美沙酮治疗的阿片类药物依赖者都吸烟，其中一半的美沙酮治疗者在 6 个月内出现阿片类药物复发。辩证行为疗法 (DBT) 技能培训已显示出解决物质使用和各种健康行为和状况的希望；然而，从未在任何人群中对其戒烟进行过评估。本研究的目的是在接受美沙酮治疗的人群中现场测试基于 DBT 技能培训的烟草依赖和阿片类药物复发预防 (DBT-Quit) 干预措施。方法：我们招募了 7 名接受美沙酮治疗的人参加 DBT-Quit 现场测试。参与者参加了 12 个每周 90 分钟的 DBT 技能培训小组，重点是正念、情绪调节和痛苦耐受技能。参与者接受了八周的尼古丁贴片，并在基线、6 周（治疗中期）和 12 周（治疗后）完成了评估。结果：除一名参与者外，所有参与者 (86%，n = 6) 都参加了至少 50% 的干预会议。参与者对干预“非常”或“基本”满意。在第 12 周时，除 1 人（86%，n = 6）外，其他人都尝试过戒烟，1 人（14%）曾在 7 天内戒烟。参与者禁烟 24 小时（14%，n = 1）、7 至 14 天（43%，n = 3）和 30 至 59 天（29%，n = 2）。与基线相比，参与者在 6 周和 12 周时每天吸烟的数量明显减少。没有参与者使用非法药物。与基线相比，在随访时，情绪调节、痛苦耐受或正念的困难没有显着差异。结论：对吸烟和阿片类药物使用障碍患者进行基于 DBT 技能培训的干预在美沙酮治疗中是可行和可接受的，可能有助于该人群预防药物复发、尝试戒烟、体验无烟日和减少吸烟. 需要更多的研究来确定基于 DBT 技能的药物复发预防和戒烟干预的最佳结构和组成部分。此外，需要一项 DBT-Quit 的随机对照试验来确定 DBT 技能培训在该人群中戒烟和预防药物复发的效果。体验无烟日，减少吸烟。需要更多的研究来确定基于 DBT 技能的药物复发预防和戒烟干预的最佳结构和组成部分。此外，需要一项 DBT-Quit 的随机对照试验来确定 DBT 技能培训在该人群中戒烟和预防药物复发的效果。体验无烟日，减少吸烟。需要更多的研究来确定基于 DBT 技能的药物复发预防和戒烟干预的最佳结构和组成部分。此外，需要一项 DBT-Quit 的随机对照试验来确定 DBT 技能培训在该人群中戒烟和预防药物复发的效果。