Werb D, Kamarulzaman A, Meacham M C, Rafful C, Fischer B, Strathdee S A, Wood E
International Centre for Science in Drug Policy, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, ON, Canada M5B 1W8; Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0507, USA.
Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Int J Drug Policy. 2016 Feb;28:1-9. doi: 10.1016/j.drugpo.2015.12.005. Epub 2015 Dec 18.
Despite widespread implementation of compulsory treatment modalities for drug dependence, there has been no systematic evaluation of the scientific evidence on the effectiveness of compulsory drug treatment.
We conducted a systematic review of studies assessing the outcomes of compulsory treatment. We conducted a search in duplicate of all relevant peer-reviewed scientific literature evaluating compulsory treatment modalities. The following academic databases were searched: PubMed, PAIS International, Proquest, PsycINFO, Web of Science, Soc Abstracts, JSTOR, EBSCO/Academic Search Complete, REDALYC, SciELO Brazil. We also searched the Internet, and article reference lists, from database inception to July 15th, 2015. Eligibility criteria are as follows: peer-reviewed scientific studies presenting original data. Primary outcome of interest was post-treatment drug use. Secondary outcome of interest was post-treatment criminal recidivism.
Of an initial 430 potential studies identified, nine quantitative studies met the inclusion criteria. Studies evaluated compulsory treatment options including drug detention facilities, short (i.e., 21-day) and long-term (i.e., 6 months) inpatient treatment, community-based treatment, group-based outpatient treatment, and prison-based treatment. Three studies (33%) reported no significant impacts of compulsory treatment compared with control interventions. Two studies (22%) found equivocal results but did not compare against a control condition. Two studies (22%) observed negative impacts of compulsory treatment on criminal recidivism. Two studies (22%) observed positive impacts of compulsory inpatient treatment on criminal recidivism and drug use.
There is limited scientific literature evaluating compulsory drug treatment. Evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms. Given the potential for human rights abuses within compulsory treatment settings, non-compulsory treatment modalities should be prioritized by policymakers seeking to reduce drug-related harms.
尽管针对药物依赖的强制治疗方式已广泛实施，但尚未对强制戒毒治疗效果的科学证据进行系统评估。
我们对评估强制治疗结果的研究进行了系统综述。我们对所有评估强制治疗方式的相关同行评审科学文献进行了重复检索。检索了以下学术数据库：PubMed、PAIS International、Proquest、PsycINFO、Web of Science、Soc Abstracts、JSTOR、EBSCO/Academic Search Complete、REDALYC、SciELO Brazil。我们还检索了互联网以及文章参考文献列表，检索时间从数据库建立至2015年7月15日。纳入标准如下：呈现原始数据的同行评审科学研究。主要关注的结果是治疗后的药物使用情况。次要关注的结果是治疗后的再次犯罪情况。
在最初确定的430项潜在研究中，有9项定量研究符合纳入标准。这些研究评估了多种强制治疗方案，包括戒毒所、短期（即21天）和长期（即6个月）住院治疗、社区治疗、团体门诊治疗以及监狱治疗。三项研究（33%）报告称，与对照干预措施相比，强制治疗没有显著效果。两项研究（22%）得出了模棱两可的结果，但未与对照条件进行比较。两项研究（22%）观察到强制治疗对再次犯罪有负面影响。两项研究（22%）观察到强制住院治疗对再次犯罪和药物使用有积极影响。
评估强制戒毒治疗的科学文献有限。总体而言，证据并不表明强制治疗方法能带来更好的结果，一些研究表明可能存在危害。鉴于强制治疗环境中存在侵犯人权的可能性，寻求减少毒品相关危害的政策制定者应优先考虑非强制治疗方式。
