Boston University School of Social Work, Boston, MA, USA.
J Addict Med. 2007 Mar;1(1):26-32. doi: 10.1097/ADM.0b013e318044e8fe.
The objective of this study was to examine, for a population of 8,258 adult injection drug users (IDUs) who all had entered a Massachusetts licensed methadone maintenance treatment program (MMT) between 1996 and 2002, client factors associated with remaining in MMT for a minimum of 1 year after program entry. Two binomial logistic regression models were developed. The first model examined the association between age, sex, race/ethnicity, parental status, employment status, educational status, health insurance status, homelessness status, having injected drugs in the past month, residential treatment use, number of overall treatment admissions, and whether a client's longest consecutive stay in MMT had lasted for 1 year or more. Second, to examine the stability of the statistical relationships identified in the first logistic regression model, a second logistic regression model examined whether there were significant differences in client level characteristics between those who used MMT for 6 months or less compared with their counterparts. Those who were older, women, those who were not homeless, those who resided with their children, those who had public health insurance, and those who had not used residential treatment were significantly more likely to have stayed in MMT for at least 1 year or more. In contrast, those who were younger, males, homeless, did not live with children, had no insurance, and had used residential treatment were significantly more likely to have stayed in MMT for 6 months or less compared with their counterparts. Those who stayed in MMT for 1 year or more were more likely to have stable lives compared with those who dropped out of MMT before a year. Providing services to improve MMT clients' employment, housing, and family stability may help improve MMT retention rates. Second, clients with a history of having used residential substance abuse treatment were more likely to stay in MMT for a shorter time period compared with their counterparts. The extent to which treatment bifurcation is a matter of choice or related to other factors needs to be further explored.
本研究的目的是考察在一个 8258 名成年注射吸毒者（IDU）的人群中，这些 IDU 均在 1996 年至 2002 年间进入了马萨诸塞州许可的美沙酮维持治疗项目（MMT），研究与进入项目后至少 1 年持续接受 MMT 治疗相关的客户因素。开发了两个二项逻辑回归模型。第一个模型考察了年龄、性别、种族/民族、父母状况、就业状况、教育状况、医疗保险状况、无家可归状况、过去一个月内注射毒品、住院治疗使用、总体治疗入院次数以及客户最长连续 MMT 治疗时间是否持续 1 年或更长时间之间的关联。其次，为了检查第一个逻辑回归模型中确定的统计关系的稳定性，第二个逻辑回归模型考察了在 MMT 中使用 6 个月或更短时间的患者与他们的对照组之间，患者特征是否存在显著差异。年龄较大、女性、无家可归者、与子女同住、有公共医疗保险者和未使用住院治疗者，持续接受 MMT 治疗至少 1 年或更长时间的可能性显著增加。相比之下，年龄较小、男性、无家可归者、与子女同住、无保险者和使用住院治疗者，与对照组相比，在 MMT 中停留 6 个月或更短时间的可能性显著增加。与那些在一年内退出 MMT 的患者相比，在 MMT 中停留 1 年或更长时间的患者的生活更稳定。为改善 MMT 患者的就业、住房和家庭稳定提供服务，可能有助于提高 MMT 的保留率。其次，有过住院药物滥用治疗史的患者，与对照组相比，更有可能在 MMT 中停留较短的时间。治疗分流在多大程度上是一种选择，还是与其他因素有关，需要进一步探讨。
