National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Drug Alcohol Rev. 2018 Jan;37(1):70-78. doi: 10.1111/dar.12528. Epub 2017 Apr 18.
We previously found that residential rehabilitation increased continuous abstinence from methamphetamine use 1 year after treatment. We examine what client and treatment characteristics predict this outcome.
Participants (n = 176) were dependent on methamphetamine and entering residential rehabilitation for methamphetamine use. Simultaneous logistic regression was used to identify independent predictors of continuous abstinence from methamphetamine use at 1 year follow-up. Measures included demographics, drug use, psychiatric comorbidity (Diagnostic and Statistical Manual of Mental Disorders, major depression, social phobia, panic disorder, schizophrenia, mania and conduct disorder), symptoms of psychosis and hostility, readiness to change, motivations for treatment and treatment characteristics (duration, rapport, group and individual counselling).
Participants stayed in treatment for a median of 8 weeks; 23% remained abstinent at 1 year. The only independent predictors of abstinence were more weeks in treatment [adjusted odds ratio (AOR) 1.2, P < 0.001], better rapport with treatment providers (AOR 2.4, P = 0.049) and receipt of individual counselling (AOR 3.7, P = 0.013), whereas injecting methamphetamine predicted not achieving abstinence (AOR = 0.25, P = 0.002). Individual counselling and good rapport increased abstinence to 45%; for injectors, longer stays in treatment (13+ weeks) were additionally needed to produce similar abstinence rates (43%).
Abstinence from methamphetamine use following residential rehabilitation could be significantly increased by providing individual counselling, maintaining good rapport with clients and ensuring longer stays for people who inject the drug. [McKetin R, Kothe A, Baker AL, Lee NK, Ross J, Lubman DI. Predicting abstinence from methamphetamine use after residential rehabilitation: Findings from the Methamphetamine Treatment Evaluation Study. Drug Alcohol Rev 2018;37:70-78].
我们之前发现,住院康复治疗可增加治疗后 1 年内持续戒除冰毒。我们研究了哪些患者特征和治疗特征可预测该结果。
参与者(n=176)依赖冰毒,且因冰毒使用问题进入住院康复治疗。同时进行逻辑回归分析,以确定 1 年随访时持续戒除冰毒的独立预测因素。测量指标包括人口统计学特征、药物使用、精神共病(《精神障碍诊断与统计手册》,重性抑郁、社交恐惧症、惊恐障碍、精神分裂症、躁狂和品行障碍)、精神病症状和敌意、改变的意愿、治疗动机和治疗特征(持续时间、治疗人员关系、团体和个体咨询)。
参与者在治疗中平均停留 8 周;23%的人在 1 年内保持戒断。戒断的唯一独立预测因素是治疗时间更长[校正比值比(AOR)1.2,P<0.001]、与治疗提供者的关系更好(AOR 2.4,P=0.049)和接受个体咨询(AOR 3.7,P=0.013),而注射冰毒则预示着无法戒断(AOR=0.25,P=0.002)。个体咨询和良好的关系可使戒断率提高到 45%;对于注射者,还需要延长治疗时间(13 周以上),才能达到类似的戒断率(43%)。
通过提供个体咨询、与患者保持良好关系并确保药物注射者的治疗时间延长,可显著提高住院康复治疗后戒除冰毒的效果。