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[新疆维吾尔自治区乌鲁木齐市吸毒者社区美沙酮维持治疗留存相关因素]

[Factors associated with retention in a community-based methadone maintenance treatment among drug users in Urumqi, Xinjiang Uigur Autonomous Region].

作者信息

Wang Jun, Li Fan, Mo Lan-rong, Li Lin, Guan Yong-sheng, Hao Chun, Yin Lu, Li Xin-xu, Chen Xi, Ruan Yu-hua, Shao Yi-ming

机构信息

National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing 100050, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Jan;28(1):37-41.

PMID:17575929
Abstract

OBJECTIVE

To explore the factors associated with retention in a community-based methadone maintenance treatment(MMT) among drug users in Urumqi.

METHODS

With national MMT guideline( drift) for heroine addicted drug users, local heroine-dependent people were admitted to community-based MMT program affiliated to Xinjiang Uigur Autonomous Region Center for Mental Health. Data on outpatients' social-demo characteristics, baseline behaviors on drug use and daily stabilized dose of drugs were entered to MMT database.

RESULTS

Up to 10, Feb. , 2006,353 persons withdrew MMT treatment among 709 heroin dependant drug users. Between 11, Aug., 2005 and 10, Feb., 2006, with median duration as 77 days, cumulative drop-out rate of 90 days and 180 days after first dose of MMT were 73.8% among 455 and 99.4% among 355 drug users, respectively. The incidence of drop-outs was 29.8 per 100 person-month. The median length of stay (days) in MMT was 68.0 (95% CI: 59.0- 78.0). Correlates of retention were found as: Being Uigur(HR = 1.35;95% CI :1.09-1.67), duration of drug use (HR =0.74; 95% CI:0.55-0.99) and stabilized dose(HR = 0.60;95% CI: 0.48-0.74) was found in multiple Cox proportional hazard regression model.

CONCLUSION

Retention of MMT among drug users in Urumqi was low. Uigur people should be given individual counseling to help them increase the compliance rate. Within the ranges of clinic dosage, adjustment of the methadone dose on an individual base might serve as an appropriate approach to increase the effectiveness of the program.

摘要

目的

探讨乌鲁木齐市吸毒人员社区美沙酮维持治疗(MMT)中与治疗保持率相关的因素。

方法

依据国家针对海洛因成瘾吸毒者的MMT指南(试行版),将当地海洛因依赖者纳入新疆维吾尔自治区精神卫生中心附属的社区MMT项目。门诊患者的社会人口学特征、吸毒基线行为及每日稳定吸毒剂量等数据录入MMT数据库。

结果

截至2006年2月10日,709名海洛因依赖吸毒者中有353人退出MMT治疗。在2005年8月11日至2006年2月10日期间,中位治疗时长为77天,455名吸毒者首次服用美沙酮后90天和180天的累计脱落率分别为73.8%和99.4%,355名吸毒者的脱落率分别为73.8%和99.4%。脱落发生率为每100人月29.8例。MMT的中位住院时长(天)为68.0(95%可信区间:59.0 - 78.0)。在多因素Cox比例风险回归模型中发现,与治疗保持相关的因素有:为维吾尔族(风险比[HR]=1.35;95%可信区间:1.09 - 1.67)、吸毒时长(HR =0.74;95%可信区间:0.55 - 0.99)和稳定剂量(HR =0.60;95%可信区间:0.48 - 0.74)。

结论

乌鲁木齐市吸毒人员的MMT治疗保持率较低。应给予维吾尔族人员个体辅导以帮助他们提高依从率。在临床剂量范围内,根据个体情况调整美沙酮剂量可能是提高该项目效果的合适方法。

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