Vivancos Roberto, Maskrey Viviene, Rumball Daphne, Harvey Ian, Holland Richard
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK.
J Public Health (Oxf). 2006 Jun;28(2):96-103. doi: 10.1093/pubmed/fdl010. Epub 2006 Apr 28.
Crack/cocaine use is an increasing problem in the UK. This study is the first to ascertain the magnitude of the crack/cocaine problem in a rural county of the UK and to determine users' needs for treatment services. A questionnaire on drug dependence and risk behaviour was completed by 306 users of drug treatment services, and focus groups were conducted with 45 self-selected crack/cocaine users. It is estimated that 31% (95% C.I., 26% to 37%) of drug users in treatment services have moderate/severe dependence on crack/cocaine. Factors associated with severe crack/cocaine dependence are severe dependence on benzodiazepines, increasing number of drugs used, engaging in sex work and non-white ethnicity. Those with severe dependence have a higher prevalence of hepatitis B and C compared with those with moderate or no dependence. All focus group participants describe a frenzied drug life so when entering treatment they require additional support to give structure to their lives to prevent relapse. Current service provision appears not to provide help to crack/cocaine users. Given the lack of pharmacological treatment, programmes should incorporate a wide range of activities and interventions to provide structure to clients' lives. Learning from ex-users was perceived as an important component of treatment.
在英国，吸食快克/可卡因的问题日益严重。本研究首次确定了英国一个乡村县快克/可卡因问题的严重程度，并确定了使用者对治疗服务的需求。306名药物治疗服务使用者完成了一份关于药物依赖和风险行为的问卷，并对45名自行选择的快克/可卡因使用者进行了焦点小组访谈。据估计，接受治疗服务的吸毒者中有31%（95%置信区间，26%至37%）对快克/可卡因有中度/重度依赖。与严重快克/可卡因依赖相关的因素包括对苯二氮卓类药物的严重依赖、使用药物数量的增加、从事性工作以及非白人种族。与中度或无依赖者相比，严重依赖者的乙型和丙型肝炎患病率更高。所有焦点小组参与者都描述了一种疯狂的吸毒生活，因此在进入治疗时，他们需要额外的支持来规划生活，以防止复发。目前的服务提供似乎并未为快克/可卡因使用者提供帮助。鉴于缺乏药物治疗，项目应纳入广泛的活动和干预措施，为服务对象的生活提供规划。向曾经的使用者学习被视为治疗的一个重要组成部分。
