Kidorf Michael, Disney Elizabeth, King Van, Kolodner Ken, Beilenson Peter, Brooner Robert K
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Addition Treatment Services BBRC, Johns Hopkins Bayview Medical Center, 5510 Nathan Shock Drive, Suite 1500, Baltimore, MD 21224, USA.
J Urban Health. 2005 Sep;82(3):456-67. doi: 10.1093/jurban/jti091. Epub 2005 Jul 13.
Participants of syringe exchange programs (SEPs) exhibit high rates of substance use disorder but remain extremely ambivalent about seeking treatment. This study evaluated the effectiveness of motivational interviewing (MI) for encouraging SEP participants to enroll in substance abuse treatment. New opioid-dependent registrants to the Baltimore Needle Exchange Program (BNEP) (n =302) completed the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and the Addiction Severity Index (ASI) and were randomly assigned to one of three treatment referral conditions: (1) MI, (2) job readiness (JR) (attention control), or (3) standard referral. Participants in each condition who expressed interest in treatment were referred to a treatment readiness group that provided further encouragement and referral to programs that were accepting new admissions. Participants were observed for 1 year following the intervention. The results showed that 10.9% of study participants enrolled in substance abuse treatment, although no condition effects were observed. White participants and those diagnosed with major depression were most likely to enter treatment. The results suggest that a single motivational interview is insufficient to motivate changes in treatment seeking in this population, whereas the identification of predictors of treatment enrollment is worthy of further investigation.
注射器交换项目（SEP）的参与者物质使用障碍发生率很高，但在寻求治疗方面仍极为矛盾。本研究评估了动机性访谈（MI）在鼓励SEP参与者参加药物滥用治疗方面的有效性。巴尔的摩针头交换项目（BNEP）的新的阿片类药物依赖登记者（n = 302）完成了《精神障碍诊断与统计手册》第四版（DSM-IV）的结构化临床访谈以及成瘾严重程度指数（ASI），并被随机分配到三种治疗转诊条件之一：（1）动机性访谈，（2）就业准备（JR）（注意力控制），或（3）标准转诊。每种条件下表示有治疗意愿的参与者被转介到一个治疗准备小组，该小组提供进一步的鼓励并转介到接受新入院患者的项目。干预后对参与者进行了1年的观察。结果显示，10.9%的研究参与者参加了药物滥用治疗，尽管未观察到条件效应。白人参与者和被诊断患有重度抑郁症的人最有可能接受治疗。结果表明，单次动机性访谈不足以促使该人群在寻求治疗方面发生改变，而确定治疗登记的预测因素值得进一步研究。
