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阿片类药物注射使用作为美沙酮维持治疗阿片类药物依赖患者治疗结局的预测因子。

Injection opioid use as a predictor of treatment outcomes among methadone-maintained opioid-dependent patients.

机构信息

Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA.

School of Social Work, Wayne State University, Detroit, MI 48201, USA.

出版信息

Addict Behav. 2019 Mar;90:191-195. doi: 10.1016/j.addbeh.2018.10.046. Epub 2018 Oct 31.

Abstract

BACKGROUND

Injection opioid use is associated with more severe health and psychosocial consequences relative to non-injection use, but few studies have examined whether injection use is associated with methadone maintenance treatment outcomes. The present study examined differential MMT outcomes among opioid injectors and non-injectors.

METHODS

Data were extracted from the clinic charts of opioid-dependent MMT patients (N = 290; n = 115 injectors) enrolled in a university-affiliated, urban MMT clinic. Injection status was examined as a predictor of short- (3-month opioid, cocaine, benzodiazepine and cannabis urine drug screens) and long- (days retained in treatment) term MMT outcomes.

RESULTS

Bivariate analyses revealed injection users were less likely to be African American and to have completed high school, were more likely to have started heroin use before age 21, to report having hepatitis C, to report a baseline cocaine use disorder, and had higher methadone doses at 3-months into treatment. Injection status significantly predicted a greater proportion of cocaine-positive urine drug screens in the first 3 months of treatment, but did not significantly predict opioid, benzodiazepine or cannabis drug screens, or length of treatment retention.

CONCLUSION

This is one of a handful of studies to examine injection status as a predictor of MMT outcomes. Injection status is associated with cocaine use early in treatment, which has implications for the focus of treatment.

摘要

背景

与非注射使用相比,注射阿片类药物的使用与更严重的健康和心理社会后果相关,但很少有研究检查注射使用是否与美沙酮维持治疗结果相关。本研究检查了阿片类药物注射者和非注射者之间的美沙酮维持治疗结果的差异。

方法

从参加大学附属城市美沙酮维持治疗诊所的阿片类药物依赖美沙酮维持治疗患者的诊所图表中提取数据(N=290;n=115 名注射者)。注射状态被检查为短期(3 个月阿片类药物、可卡因、苯二氮䓬类药物和大麻尿液药物筛查)和长期(治疗中保留的天数)美沙酮维持治疗结果的预测因素。

结果

双变量分析显示,注射使用者不太可能是非洲裔美国人,也不太可能完成高中学业,他们更有可能在 21 岁之前开始使用海洛因,报告患有丙型肝炎,报告基线可卡因使用障碍,并且在治疗的第 3 个月时接受更高剂量的美沙酮。注射状态显著预测治疗的前 3 个月内可卡因阳性尿液药物筛查的比例更高,但未显著预测阿片类药物、苯二氮䓬类药物或大麻药物筛查,或治疗保留时间。

结论

这是少数检查注射状态作为美沙酮维持治疗结果的预测因素的研究之一。注射状态与治疗早期的可卡因使用有关,这对治疗重点有影响。

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