Bach P B, Lantos J
Robert Wood Johnson Clinical Scholars Program, Department of Medicine, University of Chicago, Ill., USA.
Am J Public Health. 1999 May;89(5):662-5. doi: 10.2105/ajph.89.5.662.
This study sought to track changes in US heroin prices from 1988 to 1995 and to determine whether changes in the affordability of heroin were associated with changes in the use of heroin by users seeking methadone treatment, as indexed by methadone dose levels.
Data on the price of heroin were from the Drug Enforcement Administration; data on methadone doses were from surveys conducted in 1988, 1990, and 1995 of 100 methadone maintenance centers. Multivariable models that controlled for time and city effects were used to ascertain whether clinics in cities where heroin was less expensive had patients receiving higher doses of methadone, which would suggest that these patients had relatively higher physiological levels of opiate addiction owing to increased heroin use.
The amount of pure heroin contained in a $100 (US) purchase has increased on average 3-fold between 1988 and 1995. The average dose of methadone in clinics was positively associated with the affordability of local heroin (P < .01).
When heroin prices fall, heroin addicts require more methadone (a heroin substitute) to stabilize their addiction--evidence that they are consuming more heroin.
本研究旨在追踪1988年至1995年美国海洛因价格的变化，并确定海洛因可负担性的变化是否与寻求美沙酮治疗的使用者的海洛因使用变化相关，以美沙酮剂量水平为指标。
海洛因价格数据来自美国缉毒局；美沙酮剂量数据来自1988年、1990年和1995年对100个美沙酮维持治疗中心进行的调查。使用控制时间和城市效应的多变量模型来确定在海洛因价格较低的城市中，诊所的患者是否接受更高剂量的美沙酮，这表明这些患者由于海洛因使用增加，阿片类药物成瘾的生理水平相对较高。
1988年至1995年期间，100美元（美国）购买的纯海洛因含量平均增加了3倍。诊所中美沙酮的平均剂量与当地海洛因的可负担性呈正相关（P < .01）。
当海洛因价格下降时，海洛因成瘾者需要更多的美沙酮（一种海洛因替代品）来稳定他们的成瘾——这证明他们正在消费更多的海洛因。
