Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD (KRH, ASH, DAT, KED); Department of Psychiatry, UCSF School of Medicine, San Francisco, CA (DAT).
J Addict Med. 2019 Jul/Aug;13(4):300-305. doi: 10.1097/ADM.0000000000000498.
While most opioid use disorder (OUD) treatment providers consider opioid abstinence to be the preferred outcome, little is known about the treatment preferences of the larger population of individuals who engage in nonmedical opioid use and have not yet sought treatment. This study sought to descriptively quantify the proportion of out-of-treatment individuals with nonmedical opioid use that have abstinent and nonabstinent recovery goals.
Participants (N = 235) who engage in nonmedical opioid use and met self-reported criteria for OUD were recruited online and participated in a cross-sectional survey on recovery goals and treatment perceptions. Participants were dichotomized as having either abstinent (70.6%) or nonabstinent (29.4%) recovery goals. Participants were presented with 13 treatment options and asked which treatment they would "try first" and which treatment they thought would be the best option for long-term recovery.
Persons in the nonabstinent group were more likely to want to continue use of prescription opioids as prescribed by a physician compared with the abstinent group (χ[1] = 9.71, P = 0.002). There were no group differences regarding preference for individual OUD treatments. The most frequently endorsed treatments that participants would "try first" were physician visits (23.4%), one-on-one counseling (18.7%), and 12-step groups (13.2%), whereas the most frequently endorsed treatments for long-term recovery were one-on-one counseling (17.4%), residential treatment (16.7%), and buprenorphine (15.3%).
Public health initiatives to engage out-of-treatment individuals should take into account recovery goals and treatment preferences to maximize treatment initiation and retention.
虽然大多数阿片类药物使用障碍（OUD）治疗提供者认为戒断是首选结果，但对于尚未寻求治疗的、参与非医疗性阿片类药物使用的更大人群的治疗偏好知之甚少。本研究旨在描述性地量化未接受治疗的非医疗性阿片类药物使用者中具有戒断和非戒断康复目标的个体比例。
通过在线招募，参与者（N=235）参与了一项关于康复目标和治疗认知的横断面调查，他们参与非医疗性阿片类药物使用且自我报告符合 OUD 标准。参与者被分为具有戒断（70.6%）或非戒断（29.4%）康复目标的两类。向参与者展示了 13 种治疗选择，并询问他们会“首先尝试”哪种治疗，以及他们认为哪种治疗是长期康复的最佳选择。
与戒断组相比，非戒断组的人更有可能希望继续按照医生的规定使用处方阿片类药物（χ[1] = 9.71，P = 0.002）。两组在个体 OUD 治疗偏好方面没有差异。参与者最常选择的治疗方法是看医生（23.4%）、一对一咨询（18.7%）和 12 步团体（13.2%），而他们最常选择的长期康复治疗方法是一对一咨询（17.4%）、住院治疗（16.7%）和丁丙诺啡（15.3%）。
为接触未接受治疗的个体而开展的公共卫生举措应考虑康复目标和治疗偏好，以最大程度地提高治疗开始和保留率。
