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阿片类药物治疗的首次入院:对寻求治疗的新阿片类药物使用者的横断面描述性研究。

First-time admissions for opioid treatment: cross-sectional and descriptive study of new opioid users seeking treatment.

作者信息

Flórez Gerardo, López-Durán Ana, Triñanes Yolanda, Osorio Jesús, Fraga Jaime, Fernández José Manuel, Becoña Elisardo, Arrojo Manuel

机构信息

Addictive Disorders Assistance Unit, Complejo Hospitalario, Ourense, Spain ; Center for Biomedical Research in Mental Health (CIBERSAM), Oviedo, Spain.

Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain.

出版信息

Neuropsychiatr Dis Treat. 2015 Sep 24;11:2431-40. doi: 10.2147/NDT.S84431. eCollection 2015.

Abstract

BACKGROUND

The purpose of this study was to gain an understanding of the profiles of the new treatment demands posed by opioid addicts between 2005 and 2010 at the addictive disorders assistance units in Galicia, Spain.

METHODS

A cluster analysis was performed using data from 1,655 treatment entrants. Clusters were constructed using sociodemographic and medicolegal variables. A cluster analysis was also conducted according to age. Once clusters were defined, their association with the following variables was analyzed: age at first use of opioids, years of use, frequency of opioid use in the previous month, psychiatric treatment, cocaine use, existence of a drug-dependent partner, and source of referral.

RESULTS

Four clusters were obtained in the main analysis. Cluster 1 (34.01%) consisted of young males, cluster 2 (16.19%) consisted of not-so-young males, cluster 3 (32.62%) consisted mainly of older males and a small group of females, and cluster 4 (17.18%) was made up entirely of women. With regard to age-related clusters, two clusters were obtained in those under the age of 30 years: cluster 1 (73%) without medicolegal complications and cluster 2 (27%) with medicolegal complications. For those over the age of 30 years, two clusters were obtained: cluster 1 (53.92%) with hardly any medicolegal complications and cluster 2 (46.08%) with medicolegal complications.

CONCLUSION

Cluster analysis suggests that there have been no substantial changes in variables indicating greater severity in this new group of patients. Women are likely to seek help earlier, which reduces their duration of opioid use. The younger the patient, the shorter the duration of opioid use and the greater the likelihood of cessation of intravenous use. Public health systems should use a two-pronged treatment strategy of short but intense cessation therapies for women and younger treatment entrants and longer maintenance and replacement therapies for older treatment entrants with more psychosocial and medical complications.

摘要

背景

本研究旨在了解2005年至2010年间西班牙加利西亚成瘾障碍援助单位中阿片类药物成瘾者提出的新治疗需求概况。

方法

使用来自1655名治疗入院者的数据进行聚类分析。聚类是根据社会人口统计学和法医学变量构建的。还根据年龄进行了聚类分析。一旦定义了聚类,就分析它们与以下变量的关联:首次使用阿片类药物的年龄、使用年限、前一个月阿片类药物的使用频率、精神治疗、可卡因使用、存在药物依赖伴侣以及转诊来源。

结果

在主要分析中获得了四个聚类。聚类1(34.01%)由年轻男性组成,聚类2(16.19%)由不太年轻的男性组成,聚类3(32.62%)主要由老年男性和一小部分女性组成,聚类4(17.18%)完全由女性组成。关于与年龄相关的聚类,在30岁以下的人群中获得了两个聚类:聚类1(73%)无法律并发症,聚类2(27%)有法律并发症。在30岁以上的人群中,获得了两个聚类:聚类1(53.92%)几乎没有法律并发症,聚类2(46.08%)有法律并发症。

结论

聚类分析表明,在这组新患者中,表明病情更严重的变量没有实质性变化。女性可能更早寻求帮助,这缩短了她们使用阿片类药物的时间。患者越年轻,使用阿片类药物的时间越短,停止静脉使用的可能性越大。公共卫生系统应采用双管齐下的治疗策略,对女性和年轻的治疗入院者采用短期但强化的戒断疗法,对有更多社会心理和医疗并发症的老年治疗入院者采用更长时间的维持和替代疗法。

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