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在中国广州,新型毒品和酒精滥用是美沙酮维持治疗患者辍学及依从性差的预测因素。

Club drugs and alcohol abuse predicted dropout and poor adherence among methadone maintenance treatment patients in Guangzhou, China.

作者信息

Liu Di, Gu Jing, Xu Huifang, Hao Chun, Jiao Mingxu, Zhang Xiao, Zhao Yuteng, Andrew Babbitt, Hao Yuantao

机构信息

a Department of Medical Statistics and Epidemiology , School of Public Health, Sun Yat-sen University , Guangzhou , People's Republic of China.

b Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University , Guangzhou , People's Republic of China.

出版信息

AIDS Care. 2017 Apr;29(4):458-463. doi: 10.1080/09540121.2016.1259452. Epub 2016 Nov 30.

Abstract

Club drugs and alcohol abuse are prevalent among methadone maintenance treatment (MMT) patients. However, little is known about the association between these abuse and treatment outcomes among MMT patients. The aim of this study was to examine the prevalence of club drugs and alcohol abuse among MMT patients and to investigate the associations between these abuse and treatment outcomes - dropout and poor adherence. In this one-year cohort study conducting in Guangzhou, China, data including background characteristics, club drugs use in the last six months, alcohol use history and treatment-related information was collected. Cox regression analyses and log-binomial regression analyses were applied to identify the associations between these abuse and dropout and poor adherence, respectively. Thirty-seven participants (9.2%) admitted to the use of at least one type of club drugs in the last six months and 88 (21.9%) were identified as alcohol abusers. Of all participants, 21.0% had dropped out of treatment and 27.7% exhibited poor adherence during the study period. Adjusting for significant background variables, use of at least one type of club drugs [hazards ratio (HR) = 1.90, 95% confidence interval (CI) = 1.01-3.56] and use of methamphetamine in the last six months (HR = 2.26, 95% CI = 1.15-4.43) significantly predicted dropout. Frequency of having six or more drinks on one drinking occasion when drinking [relative risk (RR) = 1.87, 95% CI = 1.16-2.95] significantly predicted poor adherence. Our findings indicated that club drugs and alcohol abuse predicted dropout and poor adherence among MMT patients. Early identification and intervention for the abuse should be taken into consideration when developing interventions tailored to improve treatment outcomes among MMT patients.

摘要

新型毒品和酒精滥用在美沙酮维持治疗(MMT)患者中很普遍。然而,对于这些滥用行为与MMT患者治疗效果之间的关联却知之甚少。本研究的目的是调查MMT患者中新型毒品和酒精滥用的流行情况,并探究这些滥用行为与治疗效果(退出治疗和依从性差)之间的关联。在这项于中国广州开展的为期一年的队列研究中,收集了包括背景特征、过去六个月内新型毒品使用情况、饮酒史以及治疗相关信息的数据。分别应用Cox回归分析和对数二项回归分析来确定这些滥用行为与退出治疗和依从性差之间的关联。37名参与者(9.2%)承认在过去六个月内使用过至少一种新型毒品,88名(21.9%)被认定为酒精滥用者。在所有参与者中,21.0%在研究期间退出了治疗,27.7%表现出依从性差。在对显著的背景变量进行校正后,使用至少一种新型毒品[风险比(HR)=1.90,95%置信区间(CI)=1.01 - 3.56]以及在过去六个月内使用甲基苯丙胺(HR = 2.26,95% CI = 1.15 - 4.43)显著预测了退出治疗。饮酒时单次饮酒量达到或超过六杯的频率[相对风险(RR)=1.87,95% CI = 1.16 - 2.95]显著预测了依从性差。我们的研究结果表明,新型毒品和酒精滥用可预测MMT患者的退出治疗和依从性差。在制定旨在改善MMT患者治疗效果的干预措施时,应考虑对这些滥用行为进行早期识别和干预。

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