Bleich A, Gelkopf M, Schmidt V, Hayward R, Bodner G, Adelson M
Dr Miriam & Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel-Aviv Elias Sourasky Medical Center, Israel.
Addiction. 1999 Oct;94(10):1533-40. doi: 10.1046/j.1360-0443.1999.941015339.x.
This study addressed the following questions for patients after 1 year of methadone maintenance treatment (MMT); (1) What are the demographic features and past history of drug use of benzodiazepine (BZD) abusers? (2) Do BZD abusers abuse more heroin, cocaine and/or cannabis and do they receive a higher methadone dosage level? (3) Do BZD abusers suffer more from hepatitis C (HCV) and do they have more HIV/HCV risk-taking behaviors than non-abusers? (4) Do BZD abusers have more psychopathology and more emotional distress than non-abusers?
All 148 patients who completed 1 year of MMT underwent random and twice-weekly observed urine analysis for various drugs of abuse, responded to self-report questionnaires (SCL-90-R; POMS; HIV/HCV risk-taking behaviors), interviews (ASI) and underwent testing for hepatitis C. Abuse in this study is defined as any use during the 12th month of treatment.
After 1 year of MMT, more BZD abusers (n = 63) were single, had spent time in prison, were unemployed and had at least one parent with an addiction problem or mental illness in comparison to non-abusers (n = 85). They had started using heroin and cocaine earlier and currently abused more cocaine, heroin and cannabis. They had significantly more psychopathology and negative mood. They had significantly more HCV and reported more HIV/HCV risk-taking behavior.
We suggest that this group of patients is in need of more intensive pharmacological and psychological treatment.
本研究针对接受美沙酮维持治疗（MMT）1年后的患者提出了以下问题：（1）苯二氮䓬（BZD）滥用者的人口统计学特征和既往药物使用史是什么？（2）BZD滥用者是否滥用更多海洛因、可卡因和/或大麻，以及他们是否接受更高剂量的美沙酮？（3）BZD滥用者比未滥用者患丙型肝炎（HCV）的情况是否更严重，且他们是否有更多的HIV/HCV风险行为？（4）BZD滥用者是否比未滥用者有更多的精神病理学问题和更多的情绪困扰？
所有完成1年MMT的148名患者接受了随机且每周两次的各种滥用药物尿液分析，对自我报告问卷（SCL - 90 - R；POMS；HIV/HCV风险行为）做出回应，接受访谈（ASI）并接受丙型肝炎检测。本研究中的滥用定义为治疗第12个月期间的任何使用情况。
在MMT治疗1年后，与未滥用者（n = 85）相比，更多的BZD滥用者（n = 63）为单身，有入狱经历，失业，且至少有一位父母有成瘾问题或精神疾病。他们更早开始使用海洛因和可卡因，目前滥用更多的可卡因、海洛因和大麻。他们有明显更多的精神病理学问题和负面情绪。他们有明显更多的HCV，并且报告了更多的HIV/HCV风险行为。
我们建议这组患者需要更强化的药物和心理治疗。
