Nyamathi Adeline, Cohen Allan, Marfisee Mary, Shoptaw Steven, Greengold Barbara, de Castro Viviane, George Daniel, Leake Barbara
University of California, Los Angeles, School of Nursing, 2-250 Factor, Box 951702, Los Angeles, CA 90095-1702, USA.
Drug Alcohol Depend. 2009 Apr 1;101(1-2):124-7. doi: 10.1016/j.drugalcdep.2008.10.008. Epub 2008 Dec 9.
This prospective study (n=190) examined correlates of alcohol use from baseline data of a longitudinal trial conducted among moderate and heavy alcohol users receiving methadone maintenance therapy (MMT). The sample included MMT clients who were 18-55 years of age, and were receiving MMT from five large methadone maintenance clinics in the Los Angeles area. Half of the sample was heavy drinkers and nearly half (46%) reported heroin use. Using a structured questionnaire, correlates of heavy alcohol use included White and Hispanic ethnicity, and fair or poor physical health combined with older age (> or =50 years). We also found that MMT clients who were younger than 50 years, regardless of health status, were more likely to be heavy drinkers. Compared with moderate alcohol consumers, a greater number of heavy alcohol users also experienced recent victimization. To optimize MMT, alcohol screening should be part of routine assessment and alcohol treatment should be made available within MMT programs. Moreover, special consideration should be provided to the most vulnerable clients, such as the younger user, those with a long-term and current history of heavy drug use, and those victimized and reporting fair or poor health. In addition, promoting attention to general physical and mental health problems within MMT programs may be beneficial in enhancing health outcomes of this population.
这项前瞻性研究(n = 190)利用一项在接受美沙酮维持治疗(MMT)的中度和重度饮酒者中开展的纵向试验的基线数据,研究了饮酒的相关因素。样本包括年龄在18至55岁之间、在洛杉矶地区五家大型美沙酮维持治疗诊所接受MMT的患者。样本中有一半是重度饮酒者,近一半(46%)报告曾使用海洛因。通过结构化问卷发现,重度饮酒的相关因素包括白人和西班牙裔种族,以及身体状况一般或较差且年龄较大(≥50岁)。我们还发现,50岁以下的MMT患者,无论健康状况如何,更有可能是重度饮酒者。与中度饮酒者相比,更多的重度饮酒者近期也遭受过伤害。为优化MMT,酒精筛查应成为常规评估的一部分,并且MMT项目应提供酒精治疗。此外,应给予最脆弱的患者特别关注,如年轻使用者、有长期和近期重度吸毒史的人,以及遭受过伤害且报告身体状况一般或较差的人。此外,在MMT项目中促进对一般身心健康问题的关注,可能有助于改善这一人群的健康状况。