Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Addiction Treatment Services - BBRC, Johns Hopkins Bayview Medical Center, 5510 Nathan Shock Drive, Suite 1500, Baltimore, MD 21224, United States.
Drug Alcohol Depend. 2012 Jul 1;124(1-2):162-6. doi: 10.1016/j.drugalcdep.2011.12.008. Epub 2011 Dec 31.
Developing bridges between community syringe exchange programs (SEPs) and substance abuse treatment could benefit syringe exchangers and the public health. Kidorf et al. (2009) showed that motivational approaches employed at an SEP site improved rates of treatment enrollment and reduced drug use over a 4-month observation window. The present study extends this report by evaluating rates of treatment enrollment and re-enrollment over a 12-month period.
Opioid dependent individuals (n = 281) newly registered at an SEP were randomly assigned to one of three referral interventions: (1) 8 individual motivational enhancement sessions and 16 treatment readiness group sessions designed to improve treatment interest and readiness (motivated referral condition; MRC-only); (2) MRC-only with monetary incentives for attending sessions and enrolling in treatment (MRC+I); or (3) standard referral (SRC). MRC-only and MRC+I participants discharged from treatment could attend a treatment re-engagement group designed to facilitate return to treatment (MRC+I participants received incentives for attending sessions and re-enrolling in treatment).
The 4-month outcomes generally extended over 12 months. MRC+I participants were more likely to enroll in methadone maintenance than MRC-only or SRC participants, and to re-enroll in treatment following discharge. MRC+I participants also reported more days of treatment and less heroin and injection use.
The good harm reduction outcomes for many SEP participants can be enhanced through strategies designed to facilitate treatment enrollment and re-enrollment.
在社区注射器交换计划（SEPs）和药物滥用治疗之间建立桥梁可以使注射器交换者和公众受益。Kidorf 等人（2009 年）表明，在 SEP 现场采用的动机方法在 4 个月的观察窗口内提高了治疗登记率并减少了药物使用。本研究通过评估 12 个月期间的治疗登记和重新登记率来扩展该报告。
在 SEP 新注册的阿片类药物依赖者（n = 281）被随机分配到三种转诊干预措施之一：（1）8 次个体动机增强会议和 16 次治疗准备小组会议，旨在提高治疗兴趣和准备度（有动机的转诊条件；仅 MRC）；（2）仅 MRC 并为参加会议和接受治疗提供经济奖励（MRC+I）；或（3）标准转诊（SRC）。从治疗中出院的仅 MRC 和 MRC+I 参与者可以参加旨在促进重新接受治疗的治疗重新参与小组（MRC+I 参与者因参加会议和重新接受治疗而获得奖励）。
4 个月的结果通常会持续 12 个月。与仅 MRC 或 SRC 参与者相比，MRC+I 参与者更有可能参加美沙酮维持治疗，并且在出院后重新接受治疗。MRC+I 参与者还报告了更多的治疗天数，更少的海洛因和注射使用。
通过旨在促进治疗登记和重新登记的策略，可以提高许多 SEP 参与者的良好减少伤害结果。
