Liu Xuebing, Jin Xiaohan, Zhang Yingying, Zhang Lin, Li Yi, Ma Jun
Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Front Psychiatry. 2021 Mar 30;12:653662. doi: 10.3389/fpsyt.2021.653662. eCollection 2021.
Methadone maintenance treatment (MMT) is a national strategy adopted for the treatment of heroin dependency in China. The sudden outbreak of coronavirus disease 2019 (COVID-19) and the resultant social isolation in Wuhan have also had a significant negative impact on local patients undertaking MMT. In this study, 76 patients on MMT from the Wuhan First Health Clinic were selected as the research objects to investigate the effect of COVID-19 on the levels of stress, anxiety, and depression, as well as the withdrawal symptoms and craving and substance use. Our results revealed that, during the outbreak, the Perceived Stress Scale (PSS) score, HAMA score, HAMD score, and craving in the included patients was significantly higher than that at the baseline and post-epidemic ( < 0.01, < 0.01, < 0.01, < 0.01, respectively); the positive rate of morphine and methamphetamine urine test was significantly lower than that the post-epidemic ( = 0.01, < 0.01, respectively); the amount of tobacco used during the outbreak and the post-epidemic period was significantly higher than that at the baseline ( < 0.01, < 0.01, respectively), while the amount of alcohol consumed at the outbreak was significantly higher than at the baseline and the post-epidemic ( < 0.01, < 0.01, respectively). The negative emotions aroused by the COVID-19 outbreak and the accompanying social isolation to patients on MMT are an important factor of negative reinforcement that adversely affected the patients' craving for drugs and the consumption of legal substances. This finding suggests the need to strengthen the psychological counseling for patients on MMT during severe epidemic, actively alleviating the negative emotions, reducing the risk of substance abuse, and strengthening drug management after the epidemic to prevent the rise of substance (legal or illegal) abuse.
美沙酮维持治疗（MMT）是中国用于治疗海洛因依赖的一项国家策略。2019年冠状病毒病（COVID-19）的突然爆发以及武汉由此导致的社会隔离，也对当地接受MMT治疗的患者产生了重大负面影响。在本研究中，选取武汉市第一健康诊所76名接受MMT治疗的患者作为研究对象，以调查COVID-19对压力、焦虑和抑郁水平以及戒断症状、渴求及物质使用的影响。我们的结果显示，疫情期间，纳入患者的感知压力量表（PSS）评分、汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分及渴求程度均显著高于基线期和疫情后（分别为<0.01、<0.01、<0.01、<0.01）；吗啡和甲基苯丙胺尿检阳性率显著低于疫情后（分别为=0.01、<0.01）；疫情期间及疫情后烟草使用量显著高于基线期（分别为<0.01、<0.01），而疫情期间酒精摄入量显著高于基线期和疫情后（分别为<0.01、<0.01）。COVID-19爆发及随之而来的社会隔离给接受MMT治疗的患者带来的负面情绪是一种负性强化的重要因素，对患者的药物渴求及合法物质消费产生了不利影响。这一发现提示，在严重疫情期间需要加强对接受MMT治疗患者的心理咨询，积极缓解负面情绪，降低物质滥用风险，并在疫情后加强药物管理，以防止物质（合法或非法）滥用情况上升。
