Robins Lee N, Slobodyan Sergey
Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA.
Addiction. 2003 Aug;98(8):1053-60. doi: 10.1046/j.1360-0443.2003.00436.x.
To seek clues in the Vietnam study of 30 years ago that might shed light on which previous users of heroin are at special risk of relapsing and, among relapsers, to identify those likely to begin or return to injecting heroin.
To analyse information in military records and in two interviews given in the first 3 years after return from Vietnam to find predictors of post-Vietnam injection by soldiers who had used heroin while in Vietnam in 1970-71.
A total of 374 Vietnam veterans who had used heroin while in Vietnam and had been interviewed twice since their return from Vietnam.
Post-Vietnam heroin injection was determined in either of two post-Vietnam interviews. Possible predictors came from interviews and military records and describe pre-Service and in-Vietnam status and behavior. Included are region of residence, race, antisocial behavior, type and level of drug use and association with illicit drug users. Possible post-Vietnam correlates of heroin injection were no job or school enrollment, alcohol problems, depression, absent or transient marriage, association with illicit drug users and other Vietnam veterans.
Only a minority of those who used heroin in Vietnam had ever injected it there. Most smoked or snorted it. After their return, most of the men who had used heroin in Vietnam used it very occasionally or not at all. Among those who did use heroin more than five times after their return, most had tried injecting it. Significant predictors of post-Vietnam injection included living on the east or west coast, deviant behavior both before and in Vietnam, opiate use before Vietnam, serious involvement with heroin in Vietnam, use of non-opiate drugs before and in Vietnam, and associating with drug users before Service. The variables that increased significantly the probability of injection among men who relapsed to heroin use after return to the United States were living on the east or west coast and having a history of using non-opiate illegal drugs before they entered Service. Blacks who returned to heroin use after return were less likely to inject than were non-blacks.
These results suggest that a high-risk group for intervention to prevent future injection would consist of people with a history of past heroin use who are currently either in remission or using without injection and who reside on either coast, have a history of antisocial behavior and have used a variety of illicit drugs other than heroin.
探寻30年前越南研究中的线索，以揭示哪些曾经使用过海洛因的人有复吸的特殊风险，并且在复吸者中，识别出那些可能开始或重新使用注射海洛因的人。
分析军事记录以及从越南回国后头3年里进行的两次访谈中的信息，以找出1970 - 1971年在越南期间使用过海洛因的士兵在越南回国后注射海洛因的预测因素。
共有374名越南退伍军人，他们在越南期间使用过海洛因，并且从越南回国后接受过两次访谈。
通过越南回国后的两次访谈中的任何一次来确定越南回国后是否注射海洛因。可能的预测因素来自访谈和军事记录，描述入伍前和在越南期间的状况及行为。包括居住地区、种族、反社会行为、吸毒类型和程度以及与非法吸毒者的关联。越南回国后与注射海洛因可能相关的因素有无工作或未入学、酒精问题、抑郁、婚姻缺失或短暂、与非法吸毒者及其他越南退伍军人的关联。
在越南使用过海洛因的人中，只有少数人在那里注射过海洛因。大多数人是吸食或鼻吸。回国后，大多数在越南使用过海洛因的人只是偶尔使用或根本不再使用。在回国后使用海洛因超过五次的人中，大多数尝试过注射。越南回国后注射海洛因的显著预测因素包括居住在东海岸或西海岸、在入伍前和越南期间的越轨行为、入伍前使用阿片类药物、在越南严重依赖海洛因、在入伍前和越南期间使用非阿片类药物以及入伍前与吸毒者交往。在美国回国后复吸海洛因的男性中，显著增加注射可能性的变量是居住在东海岸或西海岸以及在入伍前有使用非阿片类非法药物的历史。回国后复吸海洛因的黑人比非黑人注射的可能性小。
这些结果表明，为预防未来注射行为而进行干预的高危人群包括有过去使用海洛因历史的人，他们目前要么已戒毒，要么非注射使用海洛因，并且居住在沿海地区，有反社会行为历史，且使用过海洛因以外的多种非法药物。
