Kinlock Timothy W, Battjes Robert J, Schwartz Robert P
Social Research Center, Friends Research Institute Inc, Baltimore, Maryland 21201, USA.
Am J Drug Alcohol Abuse. 2005;31(3):433-54. doi: 10.1081/ada-200056804.
Because prisoners with preincarceration heroin dependence typically relapse following release, a pilot study examined a novel opioid agonist maintenance program whereby consenting males initiated levo-alpha-acetylmethadol (LAAM) treatment shortly before release from prison with opportunity to continue maintenance in the community. Treated prisoners (experimental group) were compared with controls who received community treatment referral information only and prisoners who withdrew from treatment prior to medication regarding treatment participation and community adjustment during nine months post-release. Nineteen of 20 (95%) prisoners who initiated maintenance in prison entered community treatment, compared with 3 of 31 (10%) controls, and 1 of 13 (8%) who withdrew. Moreover, 53% of experimental participants remained in community treatment at least six months, while no other participants did so. Differences in heroin use and criminal involvement between experimental participants and each of the other two groups, while not consistently statistically significant, uniformly favored the experimental group. Despite study limitations, robust findings regarding treatment attendance suggest that this intervention is highly promising.
由于入狱前依赖海洛因的囚犯在获释后通常会复吸,一项试点研究考察了一种新型阿片类激动剂维持治疗方案,即同意参与的男性在即将出狱前开始接受左-α-乙酰美沙醇(LAAM)治疗,并有机会在社区继续维持治疗。将接受治疗的囚犯(实验组)与仅收到社区治疗转诊信息的对照组以及在用药前退出治疗的囚犯进行比较,观察他们在出狱后九个月内的治疗参与情况和社区适应情况。在监狱中开始维持治疗的20名囚犯中有19名(95%)进入了社区治疗,相比之下,对照组的31名中有3名(10%),退出治疗的13名中有1名(8%)。此外,53%的实验组参与者在社区治疗中至少持续了六个月,而其他组的参与者均未做到。实验组参与者与其他两组在海洛因使用和犯罪活动方面的差异,虽然并非始终具有统计学显著性,但总体上有利于实验组。尽管研究存在局限性,但关于治疗出勤率的有力发现表明,这种干预措施很有前景。