Gisev Natasa, Degenhardt Louisa, Larney Sarah, Larance Briony, Gibson Amy, Kimber Jo, Burns Lucy
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Drug Alcohol Rev. 2014 Sep;33(5):499-505. doi: 10.1111/dar.12151. Epub 2014 May 20.
Few population-based studies have examined differences in opioid substitution therapy (OST) treatment utilisation between men and women. Using a population of opioid-dependent people in New South Wales, Australia, first-episode and long-term OST treatment utilisation profiles were compared between men and women, differentiating between treatment initiation in the community and in custody.
Retrospective data linkage study using records of new OST entrants (2001-2010) and custody episodes (2000-2012). First OST treatment episode and overall treatment utilisation characteristics were compared between men and women initiating treatment in the community or in custody. Treatment retention was evaluated at 3, 6, 9 and 12 months after first commencing OST and overall, as the median proportion of follow-up time spent in treatment.
There were 15,600 new OST entrants in the cohort--10,930 were men (70.1%) and 4670 women (29.9%); 12,584 (80.7%) initiated treatment in the community and 3016 (19.3%) in custody. More men initiated OST in custody (24.0% vs. 8.3%, P < 0.001) and only received OST in custody (57.5% vs. 41.8%, P < 0.001). Women were retained longer in their first OST treatment episode at all four time points in both treatment settings and in treatment overall (community: 46.6% vs. 39.1%, P < 0.001; custody: 41.3% vs. 30.8%, P < 0.001).
There are a number of key differences in OST treatment utilisation profiles between men and women. Whereas men commonly initiate and only receive OST in custody, treatment retention is higher among women, independent of the setting treatment is initiated.
很少有基于人群的研究探讨过男女在阿片类药物替代疗法（OST）治疗利用方面的差异。利用澳大利亚新南威尔士州阿片类药物依赖人群，比较了男性和女性首次发作及长期OST治疗利用情况，区分了在社区和羁押场所开始治疗的情况。
采用回顾性数据关联研究，利用新OST入组者（2001 - 2010年）和羁押事件（2000 - 2012年）的记录。比较了在社区或羁押场所开始治疗的男性和女性的首次OST治疗发作及总体治疗利用特征。在首次开始OST治疗后的3、6、9和12个月以及总体上，将治疗保留率评估为随访时间中接受治疗的中位比例。
该队列中有15600名新的OST入组者，其中男性10930名（70.1%），女性4670名（29.9%）；12584名（80.7%）在社区开始治疗，3016名（19.3%）在羁押场所开始治疗。更多男性在羁押场所开始OST治疗（24.0%对8.3%，P < 0.001）且仅在羁押场所接受OST治疗（57.5%对41.8%，P < 0.001）。在两种治疗环境下的所有四个时间点以及总体治疗中，女性在首次OST治疗发作中的保留时间更长（社区：46.6%对39.1%，P < 0.001；羁押场所：41.3%对30.8%，P < 0.001）。
男女在OST治疗利用情况方面存在一些关键差异。男性通常在羁押场所开始并仅在羁押场所接受OST治疗，而女性的治疗保留率更高，与开始治疗的环境无关。
