Cohen J, Schamroth A
Department of Primary Health Care, University College, London, U.K.
Drug Alcohol Depend. 1990 Jun;25(3):315-8. doi: 10.1016/0376-8716(90)90157-a.
Eighty-five drug misusers sought help and treatment from our central London practice in the 12 months between 1st November 1987 and 31st October 1988. They were all accepted for a short course of oral methadone reduction. At the end of the 12 months, according to the best information available from records, family, friends, neighbors, support agencies and patient reports, 19 (22%) were off all illicit drugs and 9 (16%) of those who had been unemployed at presentation had obtained regular employment. On average, our opiate misusers consumed 0.5 g of heroin daily at a daily street cost of approximately 40 pounds or 14,600 pounds annually. Sixty per cent of them admitted to financing their drug habit through criminal activities. Against the huge social cost of illicit drug misuse, the cost of providing primary health care to all these 85 addicts was 8% of each two doctors' consulting time at an annual cost of 2171 pounds per GP (25 pounds per hour of GP time). Thus for the methadone reduction programme for these 85 addicts to be judged effective based on cost alone, one would require a drug abstention ("success") rate of 0.003%.
在1987年11月1日至1988年10月31日的12个月间，85名吸毒者向我们位于伦敦市中心的诊所寻求帮助和治疗。他们都接受了短期口服美沙酮递减治疗。在这12个月结束时，根据记录、家人、朋友、邻居、支持机构以及患者报告所提供的最佳信息，19人（22%）戒除了所有非法药物，而那些就诊时失业的人中有9人（16%）找到了固定工作。平均而言，我们的阿片类药物滥用者每天吸食0.5克海洛因，每天的街头花费约为40英镑，即每年14,600英镑。其中60%的人承认通过犯罪活动来筹集毒资。与非法药物滥用所造成的巨大社会成本相比，为这85名成瘾者提供初级医疗保健的成本仅占每位医生咨询时间的8%，每位全科医生的年成本为2171英镑（每小时25英镑）。因此，仅从成本角度判断，要使针对这85名成瘾者的美沙酮递减计划被视为有效，所需的戒毒（“成功”）率需达到0.003%。
