Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jiading Mental Health Center, Shanghai, China.
Addiction. 2019 Feb;114(2):259-267. doi: 10.1111/add.14451. Epub 2018 Oct 31.
To describe the polysubstance use patterns of heroin-dependent patients and to understand the impact of polysubstance use patterns on relapse during the 5 years after completing compulsory rehabilitation programmes.
In this secondary analysis, the baseline data of 503 heroin-dependent patients were linked with their 5-year follow-up data from official records.
Four compulsory rehabilitation centres in Shanghai, China.
A total of 564 heroin-dependent patients who were discharged from Shanghai compulsory rehabilitation facilities in 2007 and 2008 were recruited. Among these, 503 patients with available follow-up records were included in this analysis.
The baseline measurements included the Addiction Severity Index, the Temperament and Character Inventory and the Medical Outcomes Study Social Support Scale. Relapses after discharge from the compulsory rehabilitation centres were extracted monthly from the official electronic record system. Latent class analysis was used to identify different polysubstance use patterns. Associations between the identified latent classes and heroin use and the factors related to relapse during the 5-year follow-up were analysed with the Cox regression model.
Three latent classes were identified in this cohort: (1) alcohol polydrug users (APU; 13.7%), (2) low polydrug users (LPU; 76.5%) and (3) amphetamine-type stimulant polydrug users (ASPU; 9.7%). During the 5-year follow-up, 298 heroin patients relapsed, and the three groups showed different relapse rates (ASPU 69.4 versus LPU 60.5 versus APU 44.9%, P = 0.02). The average durations of abstinence for the three groups differed (ASPU 31.27 ± 3.41 months versus LPU 36.77 ± 1.19 months versus APU 42.46 ± 2.81 months, P = 0.02). Multivariate Cox regression analyses found that the LPU [hazard ratio (HR) = 1.63, 1.06-2.51] and ASPU (HR = 2.10, 1.24-3.56) classes were positively associated with the risk of heroin relapse.
Polydrug use patterns differ among heroin-dependent patients in compulsory rehabilitation programmes in China. A history of polydrug use may predict heroin relapse risk among patients in those compulsory rehabilitation programmes.
描述海洛因依赖患者的多物质使用模式，并了解多物质使用模式对完成强制康复计划后 5 年内复发的影响。
在这项二次分析中，将 503 名海洛因依赖患者的基线数据与他们从官方记录中获得的 5 年随访数据进行了关联。
中国上海的 4 个强制康复中心。
共招募了 2007 年和 2008 年从上海强制康复机构出院的 564 名海洛因依赖患者。其中，503 名有随访记录的患者被纳入本分析。
基线测量包括成瘾严重程度指数、气质与性格量表和医疗结局研究社会支持量表。从官方电子记录系统中每月提取从强制康复中心出院后的复发情况。使用潜在类别分析来确定不同的多物质使用模式。使用 Cox 回归模型分析鉴定出的潜在类别与海洛因使用之间的关系，以及与 5 年随访期间复发相关的因素。
在该队列中确定了 3 种潜在类别：（1）酒精多药物使用者（APU；13.7%）、（2）低多药物使用者（LPU；76.5%）和（3）苯丙胺类兴奋剂多药物使用者（ASPU；9.7%）。在 5 年的随访中，有 298 名海洛因患者复发，这 3 组的复发率不同（ASPU 为 69.4%，LPU 为 60.5%，APU 为 44.9%，P=0.02）。3 组的平均禁欲时间不同（ASPU 为 31.27±3.41 个月，LPU 为 36.77±1.19 个月，APU 为 42.46±2.81 个月，P=0.02）。多变量 Cox 回归分析发现，LPU[风险比（HR）=1.63，1.06-2.51]和 ASPU（HR=2.10，1.24-3.56）类别与海洛因复发风险呈正相关。
在中国强制康复项目中的海洛因依赖患者中，多药物使用模式存在差异。多药物使用史可能预测那些强制康复项目中患者的海洛因复发风险。
