Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL 60610, United States.
Lighthouse Institute, Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, United States.
J Subst Abuse Treat. 2018 Mar;86:30-35. doi: 10.1016/j.jsat.2017.12.007. Epub 2017 Dec 19.
The recent surge in opioid-related overdoses and related fatalities underscores the need for assertive mechanisms for linking individuals with opioid use disorders (OUD) to medication-assisted treatment (MAT). This pilot study investigated the feasibility of an intervention that used peer outreach workers to identify out-of-treatment individuals with OUD combined with a modified version of the Recovery Management Checkup to link individuals to methadone treatment. The study was conducted in high-risk communities in Chicago over 8weeks; peer outreach workers identified 88 active opioid/heroin users; 72 were screened as eligible, and 70 showed to the study intake/initial linkage meeting. Most participants were male (73%) and African American (94%), with an average age of 52.0 (sd=7.6). Nearly all (67/70, 96%) were admitted to methadone treatment; median time from initial linkage meeting to treatment admission was 2.6days. Most were still in treatment at 30 and 60days post-intake (69% and 70%, respectively). A high-risk sub-group was identified that had ever received naloxone for an opioid overdose; they had one third of the odds of being in treatment at 30days post-intake compared with others. The intervention model holds promise as an assertive method for identifying and engaging individuals with OUD into treatment.
最近阿片类药物相关过量用药和相关死亡人数的激增,突显了需要有积极的机制将患有阿片类药物使用障碍(OUD)的个人与药物辅助治疗(MAT)联系起来。这项试点研究调查了一种干预措施的可行性,该措施使用同伴外展工作者来识别未接受治疗的 OUD 个人,并结合经过修改的康复管理检查来将个人与美沙酮治疗联系起来。该研究在芝加哥的高风险社区进行了 8 周;同伴外展工作者确定了 88 名活跃的阿片类药物/海洛因使用者;72 人被筛选为符合条件,70 人参加了研究的入组/初步联系会议。大多数参与者为男性(73%)和非裔美国人(94%),平均年龄为 52.0(标准差=7.6)。几乎所有(67/70,96%)人都被接纳接受美沙酮治疗;从初步联系会议到治疗入院的中位数时间为 2.6 天。大多数人在入组后 30 天和 60 天仍在接受治疗(分别为 69%和 70%)。确定了一个高风险亚组,该亚组曾因阿片类药物过量而接受过纳洛酮治疗;与其他人相比,他们在 30 天治疗时的几率为三分之一。该干预模式具有很大的潜力,可以作为一种积极的方法,用于识别和让患有 OUD 的个人接受治疗。