National Addiction Centre (NAC), Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
School of Pharmacy, University of Auckland, New Zealand.
Addict Behav. 2011 Jun;36(6):636-642. doi: 10.1016/j.addbeh.2011.01.004. Epub 2011 Jan 13.
In New Zealand approximately 4600 people receive opioid substitution treatment (OST) for opioid dependence, primarily methadone maintenance treatment. This study explored ways in which OST could be improved, given the significant waiting times for treatment. Two parallel surveys were conducted: 1) peer interviews with 85 regular daily or almost daily opioid drug users (51.8% receiving OST, 18.8% not currently receiving OST, and 29.4% never received OST) and; 2) a census of all 18 specialist OST service providers. When asked how OST might be improved, the four categories most commonly cited by the opioid users were 'better treatment by staff', 'more flexibility', 'better takeaway arrangements', and 'decreased waiting time'. Both opioid users and specialist services rated 'restricted takeaways' and 'having to go on a waiting list' in the top three perceived barriers to OST. Almost all services reported significant resource issues and barriers to the transfer of stable clients from specialist services to continuing treatment in primary care. The findings from this study indicate how OST can be made more accessible and attractive and thus achieve better uptake and retention.
在新西兰，约有 4600 人接受阿片类药物替代治疗（OST）来治疗阿片类药物依赖，主要是美沙酮维持治疗。本研究探讨了在治疗等待时间显著的情况下，如何改进 OST。进行了两项平行调查：1）对 85 名经常或几乎每天使用阿片类药物的使用者进行同行访谈（51.8%接受 OST，18.8%目前未接受 OST，29.4%从未接受过 OST）；2）对所有 18 名专科 OST 服务提供者进行普查。当被问及 OST 如何改进时，阿片类药物使用者最常提到的四个类别是“工作人员提供更好的治疗”、“更多的灵活性”、“更好的外带安排”和“减少等待时间”。阿片类药物使用者和专科服务机构都将“限制外带”和“必须进入等候名单”列为 OST 的前三大感知障碍。几乎所有的服务机构都报告了重大的资源问题和将稳定的客户从专科服务转移到初级保健继续治疗的障碍。这项研究的结果表明，如何使 OST 更易获得和更具吸引力，从而提高利用率和保留率。
