Lundgren Lena M, Sullivan Lisa, Amodeo Maryann
Center on Work and Family, Boston University, MA 02215, USA.
J Subst Abuse Treat. 2006 Mar;30(2):121-8. doi: 10.1016/j.jsat.2005.10.007.
This study explored common drug treatment utilization patterns in the first four types of treatments entered by injection drug users (IDUs) with multiple admissions. A Massachusetts longitudinal database with all entries to all licensed drug treatment programs was used. Treatment repeaters' admission patterns varied considerably. For the years 1997-2001, there were 2,500-3,000 IDUs new to the system each year who became treatment repeaters and who had more than 250 utilization patterns. Only approximately half of these repeaters followed the 10 most common utilization patterns. The most common pattern (for 30% of the population each year) was only entering detoxification two to four times; the only other common pattern (involving 4-8% of the population) was having entered methadone maintenance twice or having entered detoxification then methadone maintenance. Studies are needed to identify the extent to which the absence of a systematic pattern is caused by client, payment, or treatment setting and systems issues. A key implication is the need to develop policies that provide support for states to develop continuum-of-care models for their drug treatment systems.
本研究探讨了多次入院的注射吸毒者（IDU）接受的前四种治疗中常见的药物治疗使用模式。研究使用了马萨诸塞州一个包含所有持牌药物治疗项目所有入院记录的纵向数据库。治疗重复者的入院模式差异很大。在1997年至2001年期间，每年有2500至3000名新进入该系统的注射吸毒者成为治疗重复者，他们有超过250种使用模式。这些重复者中只有约一半遵循10种最常见的使用模式。最常见的模式（每年占30%的人群）是只进行两到四次戒毒；唯一的其他常见模式（涉及4%至8%的人群）是接受过两次美沙酮维持治疗，或者先进行戒毒然后接受美沙酮维持治疗。需要开展研究，以确定缺乏系统模式在多大程度上是由服务对象、支付方式、治疗环境或治疗系统问题导致的。一个关键的启示是，需要制定政策，为各州制定药物治疗系统的连续护理模式提供支持。
