Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University.
University of Michigan Addiction Center, Department of Psychiatry, University of Michigan.
Psychol Addict Behav. 2018 Jun;32(4):485-495. doi: 10.1037/adb0000354. Epub 2018 Apr 12.
We examined whether acceptability of nonabstinence treatment outcome goals varied as a function of a patient's severity of diagnosis (ICD-10 harmful use vs. dependence syndrome; World Health Organization, 1992), finality of outcome goal (intermediate vs. final), and type of substance (e.g., tobacco, alcohol, cannabis), among addiction treatment providers in Ukraine. We surveyed 44% of Ukrainian treatment providers (n = 446/1023; Mage = 40.4, SD = 8.6; Male = 67%; MYears Of Experience = 10.2, SD = 7.2). For tobacco use, most respondents (78%-93%) rated nonabstinence as acceptable, regardless of diagnostic severity or finality of outcome goal (i.e., intermediate, final). Most respondents also rated nonabstinence as acceptable as an intermediate or final goal for patients with harmful use of alcohol (70% to 86%) or cannabis (71% to 93%); however, nonabstinence was less commonly indicated by respondents as an intermediate goal for patients with a dependence syndrome (alcohol = 52%; cannabis = 68%). Regarding other drug use, although most rated nonabstinence acceptable as an intermediate goal for patients with harmful use of opioids (68%) or sedatives (64%), fewer rated nonabstinence acceptable as a final goal (26% to 33%), particularly for patients with a dependence syndrome (10% to 27%). Very few providers (5% to 15%) rated nonabstinence acceptable for other substances. Patients in Ukraine who wish to moderate cannabis or tobacco use will find that their provider is typically accepting of this goal; however, providers are mixed regarding whether alcohol and opioid moderation is appropriate, particularly for those with dependence. Findings support education and research efforts to better understand how provider and patient alignment regarding goals impact patient outcomes following substance use treatment in Ukraine. (PsycINFO Database Record
我们考察了在乌克兰，成瘾治疗提供者是否会根据患者诊断的严重程度（ICD-10 有害使用与依赖综合征；世界卫生组织，1992 年）、目标结局的终局性（中间结局与最终结局）和物质类型（例如烟草、酒精、大麻）来接受非戒除治疗结局目标。我们调查了乌克兰 44%的治疗提供者（n = 446/1023；Mage = 40.4，SD = 8.6；男性 = 67%；MyearsOfExperience = 10.2，SD = 7.2）。对于烟草使用，大多数受访者（78%-93%）认为非戒除是可以接受的，无论诊断严重程度或结局目标的终局性如何（即中间结局、最终结局）。大多数受访者也认为，对于有酒精（70%-86%）或大麻（71%-93%）有害使用的患者，非戒除作为中间或最终目标也是可以接受的；然而，对于有依赖综合征的患者，非戒除作为中间目标的可能性较小，受访者的指示比例为 52%（酒精）和 68%（大麻）。关于其他药物的使用，尽管大多数受访者认为非戒除作为中间目标对有阿片类药物（68%）或镇静剂（64%）有害使用的患者是可以接受的，但较少的受访者认为非戒除作为最终目标是可以接受的（26%-33%），特别是对于有依赖综合征的患者（10%-27%）。极少数提供者（5%-15%）认为非戒除对其他物质是可以接受的。希望适度使用大麻或烟草的乌克兰患者会发现，他们的提供者通常会接受这个目标；然而，提供者对于酒精和阿片类药物的适度使用是否合适存在分歧，尤其是对于那些有依赖的患者。这些发现支持开展教育和研究工作，以更好地了解提供者和患者在目标上的一致性如何影响乌克兰接受物质使用治疗后的患者结局。
