Chutuape M A, Jasinski D R, Fingerhood M I, Stitzer M L
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
Am J Drug Alcohol Abuse. 2001 Feb;27(1):19-44. doi: 10.1081/ada-100103117.
The purpose of this study was to investigate short-term outcomes of a 3-day inpatient medical detoxification. Heroin abusers (n = 116; 66% male, 77% African-American, X = 38 years old), completed the Addiction Severity Index during detoxification, and at 1, 3, and 6 months after detoxification; 94.5% of the postdetoxification interviews were completed. During the 30 days before detoxification, mean days of self-reported use for heroin was 28, for cocaine 19, and for alcohol 14; a mean of $1,975 was spent on drugs. Across the postdetoxification interviews, mean days of reported heroin use ranged from 11 to 14; 21-30% of patients reported no heroin use, whereas 25-36% reported almost daily use. Reported use of cocaine and alcohol showed similar reductions from pre- to postdetoxification. Reports of heroin and cocaine abstinence were generally verified through urine tests. Other psychosocial factors improved as well from pre- to postdetoxification (e.g., employment increased and needle use decreased). During the 6-month evaluation, at least 41% reported engaging in formal inpatient or outpatient treatment; another 25-33% reported attending self-help groups. Engaging in formal treatment (at least 7 days duration) was associated with significantly better outcome. Nevertheless, pre- to postdetoxification changes were significant and robust for the entire study sample. These findings demonstrate that brief inpatient detoxification is followed by reduced drug use over several months and is accompanied by substantial treatment-seeking behavior. Thus brief detoxification may serve as an effective harm-reduction intervention.
本研究的目的是调查为期3天的住院药物脱毒治疗的短期效果。海洛因滥用者(n = 116;66%为男性,77%为非裔美国人,平均年龄38岁)在脱毒期间以及脱毒后1个月、3个月和6个月完成了成瘾严重程度指数评估;94.5%的脱毒后访谈得以完成。在脱毒前的30天里,自我报告的海洛因平均使用天数为28天,可卡因为19天,酒精为14天;平均花费1975美元用于购买毒品。在脱毒后的访谈中,报告的海洛因使用平均天数在11至14天之间;21 - 30%的患者报告未使用过海洛因,而25 - 36%的患者报告几乎每天都使用。报告的可卡因和酒精使用从脱毒前到脱毒后也有类似程度的减少。海洛因和可卡因戒断报告一般通过尿液检测进行核实。其他心理社会因素从脱毒前到脱毒后也有所改善(例如,就业增加,针头使用减少)。在6个月的评估中,至少41%的人报告接受了正规的住院或门诊治疗;另外25 - 33%的人报告参加了自助小组。接受正规治疗(至少持续7天)与明显更好的结果相关。然而,对于整个研究样本来说,脱毒前到脱毒后的变化是显著且稳定的。这些发现表明,短期住院脱毒治疗后,几个月内药物使用减少,同时伴有大量寻求治疗的行为。因此,短期脱毒治疗可能是一种有效的减少伤害干预措施。