美沙酮维持治疗中高剂量美沙酮治疗的马来西亚阿片类依赖者保留率更高。
Better retention of Malaysian opiate dependents treated with high dose methadone in methadone maintenance therapy.
机构信息
Pharmacogenetic Research Group, Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
出版信息
Harm Reduct J. 2010 Dec 17;7:30. doi: 10.1186/1477-7517-7-30.
BACKGROUND
Methadone is a synthetic opiate mu receptor agonist that is widely used to substitute for illicit opiates in the management of opiate dependence. It helps prevent opiate users from injecting and sharing needles which are vehicles for the spread of HIV and other blood borne viruses. This study has the objective of determining the utility of daily methadone dose to predict retention rates and re-injecting behaviour among opiate dependents.
METHODS
Subjects comprised opiate dependent individuals who met study criteria. They took methadone based on the Malaysian guidelines and were monitored according to the study protocols. At six months, data was collected for analyses. The sensitivity and specificity daily methadone doses to predict retention rates and re-injecting behaviour were evaluated.
RESULTS
Sixty-four patients volunteered to participate but only 35 (54.69%) remained active and 29 (45.31%) were inactive at 6 months of treatment. Higher doses were significantly correlated with retention rate (p < 0.0001) and re-injecting behaviour (p < 0.001). Of those retained, 80.0% were on 80 mg or more methadone per day doses with 20.0% on receiving 40 mg -79 mg.
CONCLUSIONS
We concluded that a daily dose of at least 40 mg was required to retain patients in treatment and to prevent re-injecting behaviour. A dose of at least 80 mg per day was associated with best results.
背景
美沙酮是一种合成的阿片类μ受体激动剂，广泛用于替代非法阿片类药物来管理阿片类药物依赖。它有助于防止阿片类药物使用者注射和共享针头，这些针头是 HIV 和其他血液传播病毒传播的载体。本研究的目的是确定美沙酮的日剂量是否有助于预测阿片类药物依赖者的保留率和再次注射行为。
方法
研究对象包括符合研究标准的阿片类药物依赖者。他们按照马来西亚的指南服用美沙酮，并根据研究方案进行监测。在六个月时，收集数据进行分析。评估了美沙酮日剂量对预测保留率和再次注射行为的敏感性和特异性。
结果
64 名患者自愿参加，但只有 35 名（54.69%）在治疗 6 个月后仍保持活跃，29 名（45.31%）不活跃。较高的剂量与保留率显著相关（p < 0.0001）和再次注射行为（p < 0.001）。在保留的患者中，80.0%每天服用 80 毫克或更多的美沙酮，20.0%每天服用 40 毫克至 79 毫克。
结论
我们得出结论，每天至少 40 毫克的剂量可以使患者留在治疗中，并预防再次注射行为。每天至少 80 毫克的剂量与最佳结果相关。
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