Division of Pharmacologic Therapies, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857, USA.
Int J Environ Res Public Health. 2011 Oct;8(10):4102-17. doi: 10.3390/ijerph8104102. Epub 2011 Oct 24.
Providing access to and utilization of medication assisted treatment (MAT) for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV) prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services) MAT with HIV prevention, care and treatment programs provides the best "one stop shopping" approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.
提供药物辅助治疗（MAT）的获取和利用，以治疗阿片类药物滥用和依赖，为改善公共卫生提供了重要机会。在社区中获得包括 MAT 的卫生服务，是实现广泛服务覆盖的基础。MAT 所包含的卫生服务的类型和定位，以及与初级医疗保健的整合，包括人类免疫缺陷病毒（HIV）的预防、护理和治疗服务，对于解决药物滥用和同时发生的传染病是最理想的。作为一种 HIV 预防干预措施，将 MAT 与 HIV 预防、护理和治疗计划进行整合（HIV 服务和 MAT 服务使用同一个病历），为卫生服务的利用提供了最佳的“一站式服务”方法。或者，MAT、医疗和 HIV 服务可以分别管理，但位于同一地点，以便方便利用初级保健、MAT 和 HIV 服务。第三种方法是协调护理和治疗，其中初级保健、MAT 和 HIV 服务在不同地点提供，而个案管理人员、同伴促进者或其他人员则在各个地点促进直接服务的利用。在 MAT 的各个阶段为阿片类药物依赖患者提供连续护理，可增强公共卫生和阿片类药物依赖的康复。由于注射毒品和阿片类药物依赖者是一个受到污名化和医疗剥夺权利的群体，他们有多种医疗、心理和社会需求，因此很难获得服务并在协调护理的医疗系统中进行导航。提供全面服务和医疗保健选择的 MAT 计划，可以为改善这些人的健康状况做出最大贡献，从而增强社区的健康。
