Kristensen Øistein, Vederhus John-Kåre
Avdeling for rus- og avhengighetsbehandling, Sørlandet Sykehus HF, Serviceboks 416, 4604 Kristiansand.
Tidsskr Nor Laegeforen. 2005 Oct 20;125(20):2798-801.
Treatment of drug addiction is complex; hence there is a debate in the field of what is the best approach. An honest desire to stop using drugs is the entry ticket into the self-help programmes Alcoholics Anonymous (AA) and Narcotics Anonymous (NA); these groups are a possible supplement to ordinary treatment. They employ the twelve-step programme and are found in most large cities in Norway and around the world. The usefulness of these groups has been disputed, and few Norwegian treatment facilities have developed a systematic cooperation with them. The purpose of this study was to examine whether the use of self-help groups is associated with higher rates of abstinence two years after participants started attending groups.
114 patients, 59 with alcohol addiction and 55 with drug addiction, who started in self-help groups after a drug treatment, were approached two years later with a questionnaire. The response rate was 66%; 6 (5%) patients were dead.
Intention to treat analysis showed that 38% participated in self-help programmes two years after treatment. Of regular participants, 81% had been abstinent over the previous 6 months, compared with only 26% among non-participants. Logistic regression analysis showed odds ratio = 12.6, 95% CI (4.1-38.3), p < 0.001, for participation and abstinence.
The study has several methodological problems; particularly that correlation does not necessarily indicate causality. These problems are discussed here; the conclusion is that the probability of a positive effect is strong enough to recommend participation in self-help groups as a supplement to drug addiction treatment.
药物成瘾的治疗很复杂;因此,该领域对于什么是最佳治疗方法存在争议。真诚渴望停止使用毒品是进入戒酒互助会(AA)和戒毒匿名会(NA)等自助项目的入场券;这些团体可能是常规治疗的一种补充。它们采用十二步康复计划,在挪威和世界上大多数大城市都有。这些团体的有效性一直存在争议,挪威很少有治疗机构与它们开展系统合作。本研究的目的是检验参加自助团体是否与参与者开始参加团体两年后的更高戒酒率相关。
114名患者,59名酒精成瘾患者和55名药物成瘾患者,在接受药物治疗后开始参加自助团体,两年后通过问卷调查联系他们。回复率为66%;6名(5%)患者已去世。
意向性分析显示,治疗两年后38%的患者参加了自助项目。在经常参加者中,81%在过去6个月内已戒酒,而非参加者中只有26%戒酒。逻辑回归分析显示,参加与戒酒的比值比为12.6,95%置信区间(4.1 - 38.3),p < 0.001。
该研究存在几个方法学问题;特别是相关性不一定意味着因果关系。这里讨论了这些问题;结论是积极效果的可能性足够大,足以推荐参加自助团体作为药物成瘾治疗的一种补充。