NIDA/IAS Fellow, Temple University Beasley School of Law, United States.
Professor, Temple University Beasley School of Law, United States.
Int J Drug Policy. 2013 Nov;24(6):e25-34. doi: 10.1016/j.drugpo.2013.03.010. Epub 2013 Apr 25.
The behavior of police is an important factor in drug users' access to preventive and therapeutic health services. In China, opiate users must be registered and approved by police before accessing methadone maintenance treatment (MMT).
We conducted a literature review to identify studies reporting original data about the influence of Chinese drug policing activities on MMT access and outcomes. Searches were conducted in PubMed, the Law Journal Library of HeinOnline, the Social Science Citation Index and China Academic Journals of CNKI for empirical studies conducted in China and published in academic journals between 2005 and April 2012.
The initial literature search retrieved 276 records, of which 85 were included in the review and 191 were excluded. The majority of the included papers were single-clinic observational studies. These studies reported that: (1) fear of incarceration deterred users from initiating and continuing MMT; (2) the rates of MMT referral by police were considerably lower than those by drug user peers and by community and the media; (3) police sending users to compulsory detoxification (DETOX) and reeducation through labor (RTL) centers contributed to higher rates of MMT patient dropout; (4) arrests in and around MMT clinics were not uncommon; (5) cooperation between local police and public health agencies was difficult to achieve; and (6) a limited number of trial programs were conducted to refer detainees in DETOX to MMT clinics after release, but the outcomes were not promising.
Reviewed studies report drug policing practices that appear to be impeding MMT access and reducing successful treatment outcomes. Research focusing on the nature, prevalence and severity of these effects is urgently needed. Health and public security officials in China should review and reform policies and practices of registering, monitoring, and incarcerating drug users.
警察的行为是影响吸毒者获得预防和治疗性卫生服务的一个重要因素。在中国，阿片类药物使用者在接受美沙酮维持治疗（MMT）之前，必须经过警方登记和批准。
我们进行了文献回顾，以确定报告中国禁毒执法活动对 MMT 获得和结果影响的原始数据的研究。在 PubMed、HeinOnline 法律期刊图书馆、社会科学引文索引和中国学术期刊全文数据库中，对 2005 年至 2012 年 4 月期间在中国发表的学术期刊上发表的实证研究进行了检索。
初步文献检索检索到 276 条记录，其中 85 条被纳入综述，191 条被排除。纳入的论文大多是单诊所观察性研究。这些研究报告：（1）对监禁的恐惧阻止了使用者开始和继续接受 MMT；（2）警察转介 MMT 的比例远低于吸毒者同伴、社区和媒体的转介比例；（3）警察将使用者送往强制戒毒（DETOX）和劳教（RTL）中心导致 MMT 患者脱落率较高；（4）在 MMT 诊所内外逮捕吸毒者并不罕见；（5）地方警察和公共卫生机构之间的合作很难实现；（6）开展了为数不多的试点项目，将拘留人员从 DETOX 转介到 MMT 诊所，但结果并不理想。
综述研究报告的禁毒执法做法似乎阻碍了 MMT 的获得，并降低了成功的治疗结果。迫切需要研究这些影响的性质、普遍性和严重程度。中国卫生和公安官员应审查和改革登记、监测和监禁吸毒者的政策和做法。
