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[中国9个城市1301例美沙酮维持治疗患者中与使用海洛因相关的危险因素。]

[Risk factors which were associated with heroin use during the methadone maintenance treatment among 1301 patients in 9 cities of China.].

作者信息

Cao Xiao-bin, Yin Wen-yuan, Pang Lin, Zhang Cong-bin, Xu Jin-shui, Xiao Yong-kang, Wang Chang-he, Luo Wei, Zhang Bo, Zhang Rui-min, Li Zhi-jun, Rou Ke-ming, Wu Zun-you

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. 2010 Mar;31(3):269-72.

Abstract

OBJECTIVE

To determine the proportion of heroin use among patients who were involved in community-based methadone maintenance treatment (MMT) program and to identify the risk factors associated with heroin use.

METHODS

This study was conducted in 9 MMT clinics within 3 provinces. Thirteen hundred and one patients who met the study criteria were selected from each of the five groups with different dosages of methadone users. An administrative questionnaire was applied to explore the demographics, drug abuse-related behaviors and MMT services received by the clients, etc. The prevalence of depression and anxiety among the clients were also collected by SAS and SDS. Urine samples were collected as a biological marker to indicate if heroin had been used.

RESULTS

Of the 1301 patients, 76.2% were males. The mean age was (34.6 +/- 6.5) years while 71.7% had an education level of primary school or below. The average daily dosage of methadone was (48.1 +/- 29.4) mg and self-satisfied evaluation score on treatment was 8.6. On average, 27.7% urine samples showed positive opiate evidence. Marital status, employment status, treatment retention, self-satisfied evaluation score on dosage and dropout history were found to be significantly associated with heroin use, while gender, education level and dosage had no significant association with heroin use. It seemed that risk factors that associated with heroin use were different from areas to areas.

CONCLUSION

High quality MMT clinic services, high self-satisfied score, longer treatment retention and low dropout rate seemed to have the effects of reducing the risk of ongoing heroin abuse under the methadone maintenance treatment program.

摘要

目的

确定参与社区美沙酮维持治疗(MMT)项目的患者中使用海洛因的比例,并识别与海洛因使用相关的风险因素。

方法

本研究在3个省份的9家MMT诊所开展。从五组不同美沙酮剂量使用者中每组选取1301名符合研究标准的患者。应用一份管理调查问卷来探究患者的人口统计学特征、与药物滥用相关的行为以及接受的MMT服务等。还通过SAS和SDS收集患者中抑郁和焦虑的患病率。收集尿液样本作为生物标志物以表明是否使用过海洛因。

结果

1301名患者中,76.2%为男性。平均年龄为(34.6±6.5)岁,71.7%的患者教育水平为小学及以下。美沙酮平均日剂量为(48.1±29.4)mg,治疗自我满意度评分为8.6。平均而言,27.7%的尿液样本显示存在阿片类药物阳性证据。婚姻状况、就业状况、治疗留存率、对剂量的自我满意度评分和退出治疗史被发现与海洛因使用显著相关,而性别、教育水平和剂量与海洛因使用无显著关联。似乎与海洛因使用相关的风险因素因地区而异。

结论

高质量的MMT诊所服务、高自我满意度评分、更长的治疗留存率和低退出率似乎在美沙酮维持治疗项目下具有降低持续滥用海洛因风险的作用。

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