Social Science Research Center, DePaul University, Chicago, IL, USA.
J Psychoactive Drugs. 2011 Jul-Sep;43(3):245-56. doi: 10.1080/02791072.2011.605706.
Since its development in the 1960s, researchers have extensively scrutinized methadone maintenance treatment (MMT) as a medical response to heroin addiction. Studies consistently find that MMT is more successful than other treatment models in the reduction of opiate/opioid misuse, the transmission of diseases like HIV/AIDS and hepatitis C, and criminal arrest and conviction rates. Nonetheless, a significant portion of active and former heroin addicts view MMT negatively and-perhaps as a result-MMT is vastly underused. This study examines the effects of 12-Step discourses on the opinions and treatment decisions of active heroin addicts, addicts in MMT, and addicts in 12-Step treatment programs. The study finds the abstinence/morality based discourse of drug addiction and treatment is pervasive among addicts and their non-drug using relations and peers alike; moreover, addicts have internalized this narrative, oftentimes despite their own knowledge of MMT's success and positive personal experiences. The findings suggest that the dominance of abstinence/morality narratives contributes to MMT's poor reputation among, and low use rate by current and former heroin addicts and that the power of the dominant discourse is such that it produces a desire to buy into its values and tenets even when it is against the individual's interests to do so.
自 20 世纪 60 年代发展以来，研究人员广泛研究美沙酮维持治疗（MMT）作为治疗海洛因成瘾的医学方法。研究一致发现，MMT 在减少阿片类药物/类阿片药物滥用、艾滋病毒/艾滋病和丙型肝炎等疾病的传播，以及减少逮捕和定罪率方面，比其他治疗模式更为成功。尽管如此，相当一部分活跃的和以前的海洛因成瘾者对 MMT 持负面看法，也许是因为这个原因，MMT 的使用率非常低。本研究考察了 12 步论对活跃的海洛因成瘾者、MMT 中的成瘾者和 12 步治疗计划中的成瘾者的意见和治疗决策的影响。研究发现，戒毒/道德为基础的成瘾和治疗话语在成瘾者及其非吸毒者关系和同伴中普遍存在；此外，成瘾者已经内化了这种叙述，尽管他们自己知道 MMT 的成功和积极的个人经验。研究结果表明，戒毒/道德叙事的主导地位导致 MMT 在当前和以前的海洛因成瘾者中的声誉不佳，使用率低，而且主导话语的力量如此之大，以至于即使这样做不符合个人利益，也会产生认同其价值观和教义的愿望。
