Warner Lynn A, Alegría Margarita, Canino Glorisa
School of Social Work, Rutgers University, New Brunswick, NJ 08901, USA.
Arch Gen Psychiatry. 2004 Oct;61(10):1034-41. doi: 10.1001/archpsyc.61.10.1034.
Studies of remission from drug dependence have most often been based on treatment samples, with limited generalizability to persons who may benefit from but never seek substance abuse treatment. Little is known about remission patterns among drug users in the community.
To identify patterns and predictors of remission in a community sample of drug users followed up prospectively.
Three waves of data on a range of individual and interpersonal correlates of drug abuse and health care service use were collected between April 1997 and October 2000.
Areas of metropolitan San Juan where drug sales were known to occur.
Two hundred seventy-five women aged 18 to 35 who were crack cocaine or injecting drug users.
Self-reported drug use validated with urine screens and drug use dependence criteria based on the DSM-IV.
Most (86.9%) of the women were drug dependent at baseline. By wave 3, fewer than half (42.6%) of the women were dependent, 13.8% had subthreshold disorder, and 17.8% used substances but did not endorse any dependence criteria. Cessation of use and decreases in the number of dependence criteria endorsed were significantly less likely for women with depressive symptoms (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.88-0.96; and OR, 0.88; 95% CI, 0.86-0.90; respectively), with a partner who engaged in criminal activities (OR, 0.30; 95% CI, 0.16-0.58; and OR, 0.63; 95% CI, 0.46-0.85; respectively), and who traded sex for money or drugs (OR, 0.12; 95% CI, 0.05-0.29; and OR, 0.26; 95% CI, 0.19-0.35; respectively).
Drug use patterns and rates of dependence fluctuated substantially over time among drug users recruited from the community. Findings regarding the characteristics that impede remission suggest that mental health practitioners have an important role to play in community-based outreach and interventions designed to support women's efforts to stop using drugs.
药物依赖缓解的研究大多基于治疗样本，对那些可能从药物滥用治疗中获益但从未寻求治疗的人来说，其普遍性有限。关于社区吸毒者的缓解模式知之甚少。
确定前瞻性随访的社区吸毒者样本中的缓解模式及预测因素。
在1997年4月至2000年10月期间收集了关于药物滥用及医疗服务使用的一系列个人和人际相关因素的三轮数据。
圣胡安大都市中已知有毒品交易的地区。
275名年龄在18至35岁之间的女性，她们是快克可卡因使用者或注射吸毒者。
通过尿液筛查验证的自我报告药物使用情况以及基于《精神疾病诊断与统计手册》第四版的药物使用依赖标准。
大多数（86.9%）女性在基线时存在药物依赖。到第三轮时，不到一半（42.6%）的女性仍有依赖，13.8%有阈下障碍，17.8%使用药物但未认可任何依赖标准。有抑郁症状的女性（优势比[OR]分别为0.92；95%置信区间[CI]，0.88 - 0.96；以及OR，0.88；95% CI，0.86 - 0.90）、有从事犯罪活动伴侣的女性（OR分别为0.30；95% CI，0.16 - 0.58；以及OR，0.63；95% CI，0.46 - 0.85）、以性交易换取金钱或毒品的女性（OR分别为0.12；95% CI，0.05 - 0.29；以及OR，0.26；95% CI，0.19 - 0.35）停止使用药物以及认可的依赖标准数量减少的可能性显著降低。
从社区招募的吸毒者中，药物使用模式和依赖率随时间大幅波动。关于阻碍缓解的特征的研究结果表明，心理健康从业者在旨在支持女性戒毒努力的社区外展和干预中可发挥重要作用。
