Center on Young Adult Health and Development, Department of Family Science, University of Maryland School of Public Health, College Park, MD 20742, USA.
Subst Use Misuse. 2012 Jun-Jul;47(8-9):1041-8. doi: 10.3109/10826084.2012.663273.
The Western approach to addiction treatment involves a medical or disease orientation to understanding the onset, course, and management of addiction, and a clinical goal of abstinence or very significant reductions in drug use, usually with a combination of behavioral and pharmacological interventions. Even within this Western approach, and despite several consensually accepted features of addiction, a significant mismatch remains between what this culture has come to accept as the nature of the disease and how that same culture continues to treat the disease. This paper discusses the evolution of these Western concepts over the past decade without a corresponding evolution in the nature, duration, or evaluation standards for addiction treatment. (1) Here, we take the position that continuing care and adaptive treatment protocols, combining behavioral therapies, family and social supports, and, where needed, medications show much promise to address the typically chronic, relapsing, and heterogeneous nature of most cases of serious addiction. By extension, methods to evaluate effectiveness of addiction treatment should focus upon the functional status of patients during the course of their treatment instead of post-treatment, as is the evaluation practice used with most other chronic illnesses.
西方的成瘾治疗方法涉及到对成瘾的发生、过程和管理的医学或疾病导向，以及临床目标是戒除或显著减少药物使用，通常结合行为和药物干预。即使在这种西方方法中，尽管成瘾有几个公认的特征，但这种文化对疾病性质的接受程度与该文化继续治疗疾病的方式之间仍然存在显著的不匹配。本文讨论了过去十年中这些西方概念的演变，而成瘾治疗的性质、持续时间或评估标准却没有相应的演变。在这里，我们认为，持续护理和适应性治疗方案，结合行为疗法、家庭和社会支持，以及在需要时使用药物，为解决大多数严重成瘾病例的典型慢性、复发性和异质性问题提供了很大的希望。因此，评估成瘾治疗效果的方法应该关注患者在治疗过程中的功能状态，而不是像大多数其他慢性疾病那样在治疗后进行评估。
