Fox Aaron D, Chamberlain Adam, Frost Taeko, Cunningham Chinazo O
a Department of Medicine , Albert Einstein College of Medicine , Bronx , New York , USA.
Subst Abus. 2015;36(2):155-60. doi: 10.1080/08897077.2015.1011820.
Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients.
Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. Multivariable logistic regression was used to determine factors associated with harm reduction agency preference.
Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), whereas fewer preferred general medical clinics (13%), drug treatment programs (12%), or were not interested in BMT (25%). In multivariable analysis, experiencing ≥1 barrier to BMT was strongly associated with preferring harm reduction agencies (adjusted odds ratio [aOR] = 3.39, 95% confidence interval [CI]: 1.00-11.43).
The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT. Offering BMT at harm reduction agencies could improve access to treatment, but studies are needed to determine safety and efficacy of this approach.
减少伤害机构通过提供多种服务来补充成瘾治疗,这些服务可改善吸毒者的健康状况。丁丙诺啡维持治疗(BMT)是一种有效的阿片类药物成瘾治疗方法,可在灵活的场所提供,其中可能包括减少伤害机构。本研究调查了减少伤害服务对象对BMT不同潜在场所(减少伤害机构、普通医疗诊所和戒毒治疗项目)的态度。
通过基于计算机的访谈,参与者表明BMT的首选潜在场所(减少伤害机构、戒毒治疗项目或普通医疗诊所)、对各潜在场所BMT的兴趣、治疗动机以及接受BMT的障碍。采用多变量逻辑回归确定与偏好减少伤害机构相关的因素。
在102名阿片类药物使用者中,BMT的首选潜在场所是减少伤害机构(51%),而较少有人选择普通医疗诊所(13%)、戒毒治疗项目(12%)或对BMT不感兴趣(25%)。在多变量分析中,经历≥1个BMT障碍与更偏好减少伤害机构密切相关(调整后的优势比[aOR]=3.39,95%置信区间[CI]:1.00-11.43)。
在减少伤害机构启动BMT的可能性在减少伤害服务对象中非常有利,尤其是在那些面临BMT障碍的人群中。在减少伤害机构提供BMT可以改善治疗的可及性,但需要进行研究以确定这种方法的安全性和有效性。