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以色列美沙酮维持治疗项目中女性患者的儿童期性虐待、创伤后应激障碍与海洛因使用情况

Childhood sexual abuse, post-traumatic stress disorder, and use of heroin among female clients in Israeli methadone maintenance treatment programs (MMTPS).

机构信息

School of Social Work and Social Welfare, Hebrew University, Jerusalem, Israel.

出版信息

Soc Work Health Care. 2010;49(9):799-813. doi: 10.1080/00981381003745103.

Abstract

This study investigated association between post-traumatic stress disorder (PTSD) and a 1-year follow-up heroin use among female clients in methadone clinics in Israel. Participants were 104 Israeli female clients from four methadone clinics (Mean age = 39.09, SD = 8.61) who reported victimization to childhood sexual abuse. We tested traces in urine of these female clients for heroin a year preceding and a year following the assessment of their PTSD. Results show that 54.2% reported symptoms that accedes the DSM-IV criteria for PTSD. We found that among childhood victimized women PTSD is associated with more frequent use of heroin at a 1-year follow-up even after controlling for duration of the stay at the clinic, background, other traumatic experiences and heroin use a year prior the assessment of their PTSD. This study shows the potential long-run negative consequences of childhood sexual abuse. Not only are these sexually abused women trapped into drug dependence and addiction, they cannot break the vicious cycle of continuing the use of illicit drugs even when treated for their addiction. One major practice implication is that treatment for PTSD proven efficacious will be provided in the methadone and other drug treatment services.

摘要

本研究调查了创伤后应激障碍(PTSD)与以色列美沙酮诊所女性患者 1 年后海洛因使用之间的关联。参与者是来自四个美沙酮诊所的 104 名以色列女性患者(平均年龄=39.09,SD=8.61),她们报告了童年性虐待的受害经历。我们检测了这些女性患者在 PTSD 评估前一年和后一年的尿液中的海洛因痕迹。结果显示,54.2%的人报告的症状符合 DSM-IV 创伤后应激障碍标准。我们发现,在童年受虐待的女性中,即使在控制了在诊所的逗留时间、背景、其他创伤经历和 PTSD 评估前一年的海洛因使用后,PTSD 仍与 1 年后更频繁地使用海洛因有关。这项研究表明了童年性虐待的潜在长期负面影响。这些遭受性虐待的女性不仅陷入了药物依赖和成瘾,而且即使在治疗成瘾时,也无法打破继续使用非法药物的恶性循环。一个主要的实践意义是,将在美沙酮和其他药物治疗服务中提供已被证明有效的 PTSD 治疗。

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