Lubman Dan I, Garfield Joshua B B, Manning Victoria, Berends Lynda, Best David, Mugavin Janette M, Lam Tina, Buykx Penny, Larner Andrew, Lloyd Belinda, Room Robin, Allsop Steve
Turning Point and Monash University, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia.
Centre for Health and Social Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia.
BMC Psychiatry. 2016 Jul 19;16:250. doi: 10.1186/s12888-016-0956-9.
People seeking treatment for substance use disorders often have additional health and social issues. Although individuals presenting with alcohol as the primary drug of concern (PDOC) account for nearly half of all treatment episodes to the Australian alcohol and other drug (AOD) service system, previous treatment cohort studies have focused only on the profile of Australian heroin or methamphetamine users. While studies overseas indicate that clients seeking treatment primarily for their drinking are less likely to experience social and economic marginalisation than those seeking treatment primarily for illicit or pharmaceutical drug use, very little research has directly compared individuals presenting with alcohol as the PDOC to those primarily presenting with other drugs as their PDOC.
Seven hundred and ninety-six participants were recruited at entry to specialist AOD treatment in Victoria and Western Australia, and completed measures of demographic and social factors, substance use, quality of life, service use, and criminal justice involvement. We compared those with alcohol as their PDOC to those with other drugs as their PDOC using Pearson chi-square and Mann-Whitney U tests.
Rates of social disadvantage, poor quality of life, high severity of substance dependence, and past-year AOD, mental health, acute health, and social service use were high in all groups. However, participants with alcohol as the PDOC were older; more likely to have an educational qualification; less likely to report criminal justice involvement, housing/homelessness service use, tobacco smoking, or problems with multiple substances; and reported better environmental quality of life; but were more likely to have used ambulance services, than those with other drugs as their PDOC.
While those seeking treatment primarily for alcohol problems appear less likely to suffer some forms of social and economic disadvantage or to use multiple substances than those with a primary drug problem, they experience similarly high levels of substance dependence severity and mental health and AOD service use. These findings reinforce the need for AOD services to integrate or coordinate care with programs that address the many complexities clients frequently present with, while also acknowledging differences between those seeking treatment for alcohol versus other drug problems.
寻求物质使用障碍治疗的人往往还存在其他健康和社会问题。尽管以酒精作为主要关注药物（PDOC）的个体占澳大利亚酒精及其他药物（AOD）服务系统所有治疗案例的近一半，但以往的治疗队列研究仅聚焦于澳大利亚海洛因或甲基苯丙胺使用者的情况。虽然海外研究表明，主要因饮酒而寻求治疗的客户比主要因非法或药用药物使用而寻求治疗的客户更不容易经历社会和经济边缘化，但很少有研究直接将以酒精作为PDOC的个体与主要以其他药物作为PDOC的个体进行比较。
在维多利亚州和西澳大利亚州，796名参与者在进入AOD专科治疗时被招募，并完成了人口统计学和社会因素、物质使用、生活质量、服务使用以及刑事司法参与情况的测量。我们使用Pearson卡方检验和Mann-Whitney U检验，将以酒精作为PDOC的参与者与以其他药物作为PDOC的参与者进行了比较。
所有组中社会劣势、生活质量差、物质依赖严重程度高以及过去一年中使用AOD、心理健康、急性健康和社会服务的比例都很高。然而，以酒精作为PDOC的参与者年龄更大；更有可能拥有教育资格；报告刑事司法参与、住房/无家可归服务使用、吸烟或多种物质问题的可能性更小；并报告环境生活质量更好；但比以其他药物作为PDOC的参与者更有可能使用过救护车服务。
虽然主要因酒精问题寻求治疗的人似乎比主要有药物问题的人更不容易遭受某些形式的社会和经济劣势或使用多种物质，但他们的物质依赖严重程度以及心理健康和AOD服务使用水平同样很高。这些发现强化了AOD服务需要与解决客户经常面临的诸多复杂问题的项目整合或协调护理的必要性，同时也承认因酒精问题寻求治疗者与因其他药物问题寻求治疗者之间的差异。
