Stark M J
Lewis and Clark College, Portland, OR 97219.
J Subst Abuse Treat. 1989;6(3):169-81. doi: 10.1016/0740-5472(89)90004-4.
Methadone maintenance has become the treatment of choice for heroin addiction because of its beneficial effects on illicit opiate use and criminality. Yet methadone maintenance falls short in a variety of ways; methadone clients continue to use drugs, experience high rates of psychopathology and alcoholism, and fail to become employed and integrated into the community. These problems are endemic in addicts, but also can be attributed to a host of strategic and tactical failures in methadone maintenance treatment itself. Traditional counseling is an inadequate and confused way to provide clients with the living skills, psychotherapy, and limit setting they need. S.T.A.R. is a methadone program in Portland, Oregon, that emphasizes direct training of educational, recreational, and personal skills. Group treatment is employed to create social support for clients while psychotherapy and crisis counseling are available on an as-needed basis. Implementation of the model has caused some difficulties and has led to creative and promising results.
由于美沙酮维持治疗对非法阿片类药物使用和犯罪行为具有有益影响，它已成为海洛因成瘾的首选治疗方法。然而，美沙酮维持治疗在很多方面存在不足；服用美沙酮的患者继续使用毒品，患有精神病理学和酒精中毒的比例很高，并且未能就业并融入社区。这些问题在成瘾者中很普遍，但也可归因于美沙酮维持治疗本身在一系列战略和战术上的失败。传统咨询是一种为患者提供他们所需的生活技能、心理治疗和设定限制的不充分且混乱的方式。S.T.A.R. 是俄勒冈州波特兰的一个美沙酮项目，该项目强调对教育、娱乐和个人技能的直接培训。采用小组治疗为患者创造社会支持，同时根据需要提供心理治疗和危机咨询。该模式的实施带来了一些困难，但也取得了富有创造性和前景的成果。
