Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts 02478, USA.
Am J Addict. 2013 Jan;22(1):18-22. doi: 10.1111/j.1521-0391.2013.00317.x.
Early dropout is common in substance abuse treatment settings and may lead to poorer outcomes relative to those completing a full course of treatment. Attempts to identify predictors of dropout have yielded mixed results, highlighting the need for additional research in this area to clarify risk and protective factors to guide intervention and retention efforts. This study evaluated predictors of dropout from psychosocial treatment among opioid-dependent patients on methadone maintenance therapy.
Participants included 78 patients who had failed to respond to at least 4 months of methadone maintenance plus group counseling with clinic substance abuse counselors, and were enrolled in a study of randomized psychosocial treatment in addition to treatment-as-usual. Several factors that have been implicated in previous studies as well as two affective variables (distress intolerance and coping motives for drug use) were examined.
Results indicated that when controlling for various risk factors, age was the only significant predictor of dropout, with younger patients more likely to discontinue treatment early.
This study replicates previous findings in opioid-dependent samples that younger patients are at an increased risk of early treatment dropout.
Targeted intervention may be needed to retain young patients in drug abuse treatment.
在物质滥用治疗环境中，早期辍学很常见，与完成完整疗程的患者相比，可能导致较差的结果。尝试确定辍学的预测因素的结果喜忧参半，这突出表明需要在该领域进行更多的研究，以明确风险和保护因素，为干预和保留努力提供指导。本研究评估了美沙酮维持治疗的阿片类药物依赖患者从心理社会治疗中辍学的预测因素。
参与者包括 78 名患者，他们在接受至少 4 个月的美沙酮维持治疗和诊所药物滥用顾问的小组咨询后没有反应，并且在接受常规治疗之外还参加了一项随机心理社会治疗的研究。检查了以前研究中涉及的几个因素以及两个情感变量（痛苦耐受力和使用药物的应对动机）。
结果表明，在控制各种风险因素后，年龄是辍学的唯一显著预测因素，年轻患者更有可能早期停止治疗。
本研究复制了以前在阿片类药物依赖样本中的发现，即年轻患者有更高的早期治疗辍学风险。
可能需要针对年轻患者进行有针对性的干预，以保留他们接受药物滥用治疗。
