Wartenberg A A
Substance Abuse Treatment Center, Roger Williams General Hospital, Providence, RI 02908.
J Gen Intern Med. 1991 Jan-Feb;6(1 Suppl):S35-40. doi: 10.1007/BF02599256.
Intravenous drug users (IVDUs) are increasingly encountered in the medical arena, on both an inpatient and an outpatient basis, in large part because of complications related to the human immunodeficiency virus (HIV). Clinicians must work to overcome long-standing antipathy towards this population in order to provide appropriate care, as well as to develop an understanding of the process of addiction and of the addict as a patient. The use of relationship skills, limit setting, and contingency contracting and an ability to choose and gain access to appropriate and/or available chemical dependency treatment options are important in the care of these patients. Finally, an adequate biomedical knowledge base of the medical complications of IVDUs, as well as the care of drug-related complications and withdrawal and overdose syndromes, is necessary to provide optimal care. In addition, the IVDU may have certain features of HIV-related disease that differ from those of other groups, and the clinician must be familiar with these features. Provision of such care is within the scope of the primary care clinician and can improve patient retention in treatment and the outcomes of such treatment, as well as both patient and clinician satisfaction.
静脉注射吸毒者（IVDUs）越来越多地出现在医疗领域，无论是住院患者还是门诊患者，很大程度上是因为与人类免疫缺陷病毒（HIV）相关的并发症。临床医生必须努力克服长期以来对这一群体的反感，以便提供适当的护理，并了解成瘾过程以及成瘾者作为患者的情况。运用关系技巧、设定界限、应急契约以及选择并获得适当和/或可用的药物依赖治疗方案的能力，对于这些患者的护理很重要。最后，拥有关于IVDUs医疗并发症以及药物相关并发症、戒断和过量综合征护理的充分生物医学知识基础，对于提供最佳护理是必要的。此外，IVDUs可能具有与其他群体不同的某些HIV相关疾病特征，临床医生必须熟悉这些特征。提供此类护理属于初级保健临床医生的职责范围，并且可以提高患者在治疗中的留存率以及此类治疗的效果，同时提高患者和临床医生的满意度。
