Novick D M, Pascarelli E F, Joseph H, Salsitz E A, Richman B L, Des Jarlais D C, Anderson M, Dole V P, Nyswander M E
Department of Medicine, Beth Israel Medical Center, New York, NY 10003.
JAMA. 1988 Jun 10;259(22):3299-302.
Medical maintenance is the treatment by primary care physicians of rehabilitated methadone maintenance patients who are stable, employed, not abusing drugs, and not in need of supportive services. In this research project, physicians with experience in drug abuse treatment provided both the pharmacologic treatment of addiction as well as therapy for other medical problems, as needed. Decisions regarding treatment were based on the individual needs of the patient and on currently accepted medical practice rather than on explicit regulations. We studied the first 40 former heroin addicts who were transferred to this program from more conventional methadone clinics. At a follow-up visit at 12 to 55 months, 33 (82.5%) of 40 patients had remained in treatment; five (12.5%) had been discharged because of cocaine abuse and two (5%) had been voluntarily discharged. Personal benefits of medical maintenance include the dignity of a standard professional atmosphere and a more flexible reporting schedule. This program has the potential for improving treatment of selected methadone maintenance patients.
医疗维持治疗是由初级保健医生对已康复的美沙酮维持治疗患者进行的治疗，这些患者病情稳定、有工作、不滥用药物且不需要支持性服务。在这个研究项目中，有药物滥用治疗经验的医生根据需要既提供成瘾的药物治疗，也提供其他医疗问题的治疗。关于治疗的决策基于患者的个体需求和当前公认的医疗实践，而非明确的规定。我们研究了从更传统的美沙酮诊所转入该项目的首批40名 former heroin addicts。在12至55个月的随访中，40名患者中有33名（82.5%）继续接受治疗；5名（12.5%）因滥用可卡因已出院，2名（5%）自愿出院。医疗维持治疗的个人益处包括标准专业氛围带来的尊严感和更灵活的报告安排。该项目有可能改善对选定的美沙酮维持治疗患者的治疗。
