Cambridge Health Alliance, Department of Psychiatry, Harvard Medical School, United States.
J Subst Abuse Treat. 2010 Jul;39(1):41-50. doi: 10.1016/j.jsat.2010.03.014.
Outpatient-based opioid treatment (OBOT) with buprenorphine is an important treatment for people with opioid dependence. No quantitative empirical research has examined rationales for use of illicit buprenorphine by U.S. opioid-dependent treatment seekers. The current study sequentially screened OBOT admissions (n = 129) during a 6-month period in 2009. This study had two stages: (a) a cross-sectional epidemiological analysis of new intakes and existing patients already receiving a legal OBOT prescription (n = 78) and (b) a prospective longitudinal cohort design that followed 76% of the initial participants for 3 months of treatment (n = 42). The primary aims were to establish 2009 prevalence rates for illicit buprenorphine use among people seeking OBOT treatment, to use quantitative methods to investigate reasons for this illicit use, and to examine the effect of OBOT treatment on illicit buprenorphine use behavior. These data demonstrate a decrease in illicit use when opioid-dependent treatment seekers gain access to legal prescriptions. These data also suggest that the use of illicit buprenorphine rarely represents an attempt to attain euphoria. Rather, illicit use is associated with attempted self-treatment of symptoms of opioid dependence, pain, and depression.
基于门诊的丁丙诺啡戒毒治疗（OBOT）是治疗阿片类药物依赖患者的重要方法。目前还没有任何定量实证研究来检验美国阿片类药物依赖戒毒治疗寻求者使用非法丁丙诺啡的理由。本研究在 2009 年的 6 个月期间，连续筛查了 OBOT 入院患者（n = 129）。该研究有两个阶段：（a）对新摄入和已经接受合法 OBOT 处方的现有患者（n = 78）进行横断面流行病学分析；（b）对 76%的初始参与者进行为期 3 个月的前瞻性纵向队列设计（n = 42）。主要目的是确定 2009 年寻求 OBOT 治疗的阿片类药物依赖者中非法使用丁丙诺啡的流行率，使用定量方法调查这种非法使用的原因，并检查 OBOT 治疗对非法使用丁丙诺啡行为的影响。这些数据表明，当阿片类药物依赖者获得合法处方时，非法使用的情况会减少。这些数据还表明，非法使用丁丙诺啡很少是为了获得快感。相反，非法使用与试图自我治疗阿片类药物依赖、疼痛和抑郁的症状有关。
