National Development and Research Institutes, Inc, 71 West 23rd Street, 8th Fl, New York, NY 10010, USA.
Subst Abuse Treat Prev Policy. 2010 Sep 21;5:23. doi: 10.1186/1747-597X-5-23.
Injection drug users (IDUs) are at high risk for HIV, hepatitis, overdose and other harms. Greater drug treatment availability has been shown to reduce these harms among IDUs. Yet, little is known about changes in drug treatment availability for IDUs in the U.S. This paper investigates change in drug treatment coverage for IDUs in 90 metropolitan statistical areas (MSAs) during 1993-2002.
We define treatment coverage as the percent of IDUs who are in treatment. The number of IDUs in drug treatment is calculated from treatment entry data and treatment census data acquired from the Substance Abuse and Mental Health Service Administration, divided by our estimated number of IDUs in each MSA.
Treatment coverage was low in 1993 (mean 6.7%; median 6.0%) and only increased to a mean of 8.3% and median of 8.0% coverage in 2002.
Although some MSAs experienced increases in treatment coverage over time, overall levels of coverage were low. The persistence of low drug treatment coverage for IDUs represents a failure by the U.S. health care system to prevent avoidable harms and unnecessary deaths in this population. Policy makers should expand drug treatment for IDUs to reduce blood-borne infections and community harms associated with untreated injection drug use.
注射吸毒者（IDUs）面临感染艾滋病毒、肝炎、过量用药和其他危害的高风险。更多的毒品治疗方法的普及被证明可以降低 IDUs 面临的这些危害。然而，在美国，IDUs 可获得的毒品治疗方法的变化情况鲜为人知。本文研究了 1993-2002 年美国 90 个大都市区（MSAs）中 IDUs 的毒品治疗覆盖率的变化情况。
我们将治疗覆盖率定义为接受治疗的 IDUs 的比例。从物质滥用和心理健康服务管理局获得的治疗进入数据和治疗普查数据中计算出接受毒品治疗的 IDUs 的数量，除以我们在每个 MSA 中估计的 IDUs 数量。
1993 年治疗覆盖率较低（平均 6.7%；中位数 6.0%），到 2002 年仅增加到平均 8.3%和中位数 8.0%的覆盖率。
尽管一些 MSAs 随着时间的推移治疗覆盖率有所增加，但总体覆盖率仍然较低。IDUs 的药物治疗覆盖率低持续存在，表明美国医疗保健系统未能在该人群中预防可避免的伤害和不必要的死亡。政策制定者应扩大 IDUs 的药物治疗范围，以减少与未经治疗的注射吸毒相关的血液传播感染和社区危害。
