DeMaria P A, Sterling R, Weinstein S P
Department of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, Pa. 19107, USA.
Am J Addict. 2000 Spring;9(2):145-53. doi: 10.1080/10550490050173217.
While methadone maintenance treatment (MMT) has been demonstrated to be an effective treatment for opiate dependence, its impact on the treatment outcome of other illicit drug abuse is not as clear. Using the initial urine drug screen (UDS) and follow-up UDS at 1, 6, 12, and 24 months, 167 patients consecutively admitted to MMT were evaluated for opiate, sedative (predominantly benzodiazepine), and stimulant (predominantly cocaine) use. Retention for the opiate only group was 97.32 days longer on average than for patients using opiates along with stimulants, sedatives, or both stimulants and sedatives. Patients abusing opiates only had the greatest decrease in drug use; however, MMT was also associated with decreases in cocaine and sedative use over the 24 month follow-up period. There was no evidence that patients "switched" their drugs of abuse with time in treatment. The negative impact of non-opiate drug use on outcome in MMT and its implications for treatment planning are discussed.
虽然美沙酮维持治疗（MMT）已被证明是治疗阿片类药物依赖的有效方法，但其对其他非法药物滥用治疗结果的影响尚不清楚。利用初始尿液药物筛查（UDS）以及在1、6、12和24个月时的随访UDS，对连续接受MMT治疗的167名患者的阿片类药物、镇静剂（主要是苯二氮卓类）和兴奋剂（主要是可卡因）使用情况进行了评估。仅使用阿片类药物的患者组的留存时间平均比同时使用阿片类药物和兴奋剂、镇静剂或同时使用兴奋剂和镇静剂的患者长97.32天。仅滥用阿片类药物的患者药物使用减少最多；然而，在24个月的随访期内，MMT也与可卡因和镇静剂使用的减少有关。没有证据表明患者在治疗过程中会随着时间“转换”其滥用药物。讨论了非阿片类药物使用对MMT结果的负面影响及其对治疗计划的影响。
