Cullen W, Bury G, Barry J, O'Kelly F
Department of General Practice, University College Dublin.
Ir Med J. 2000 Oct;93(7):214-7.
Dublin has an estimated 13,460 opiate drug users. The role of general practice in providing care for this group has increased over the last four years. A Central Methadone Treatment List (CMTL) registers all clients currently on treatment. To obtain a social, demographic and drug using profile of opiate users attending general practitioners (GPs) for methadone maintenance. A cross sectional survey of opiate users attending general practice for methadone maintenance in the Dublin area in early 1999. Data was collected on 571 clients (62% of total number attending general practice), of whom 97% had used heroin in the past and 12% had never injected. Although clients had been receiving methadone maintenance in general practice for a mean of 14 months, 16% were still using heroin, of whom 31% were still injecting. The mean age of first drug use was 15.5 years and of first injecting was 19.4 years. Younger clients are starting both to use drugs and inject drugs at an earlier age. Record keeping was good, with most items of information present in over 70% of the charts surveyed. A total of 17% of clients recorded on the CMTL could not be traced to the GP recorded as providing care. Despite treatment with methadone maintenance, there is a high level of continued risk activity in this group. Furthermore, a trend towards earlier initiation to drug use is apparent. The CMTL registration process requires further exploration.
都柏林估计有13460名阿片类药物使用者。在过去四年中,全科医疗在为这一群体提供护理方面所起的作用有所增加。中央美沙酮治疗名单(CMTL)登记了所有目前正在接受治疗的患者。为了获取在全科医生(GP)处接受美沙酮维持治疗的阿片类药物使用者的社会、人口统计学和吸毒情况资料。1999年初对都柏林地区在全科医疗中接受美沙酮维持治疗的阿片类药物使用者进行了一项横断面调查。收集了571名患者的数据(占在全科医疗就诊总数的62%),其中97%的人过去使用过海洛因,12%的人从未注射过。尽管患者在全科医疗中接受美沙酮维持治疗的平均时间为14个月,但仍有16%的人在使用海洛因,其中31%的人仍在注射。首次吸毒的平均年龄为15.5岁,首次注射的平均年龄为19.4岁。较年轻的患者开始吸毒和注射毒品的年龄更小。记录保存情况良好,在超过70%的调查图表中都有大多数信息项。在CMTL上记录的患者中,共有17%无法追溯到记录中提供护理的全科医生。尽管进行了美沙酮维持治疗,但该群体中持续存在高风险活动。此外,吸毒开始时间提前的趋势很明显。CMTL的登记过程需要进一步探讨。