Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA.
Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
J Psychoactive Drugs. 2022 Nov-Dec;54(5):440-451. doi: 10.1080/02791072.2021.2009068. Epub 2021 Nov 25.
In this study using 2015-2018 Treatment Episode Data Set-Discharge (TEDS-D) cases age 55+ for heroin (N = 101,524) or prescription opioids (PO; N = 25,510) as the primary substance, we examined treatment completion rates and correlates. We fit separate logistic regression models for heroin and PO cases with treatment completion status (completed vs. discontinued due to dropout/termination/other reasons) for each treatment setting (detoxification, residential rehabilitation, and outpatient) as the dependent variable. Results show that detoxification cases had the highest completion rates and outpatient cases had the lowest (14.8% for heroin and 24.0% for PO cases). A consistently significant correlate of treatment completion was legal system referral for heroin cases and having a bachelor's degree for PO cases. Medication-assisted therapy was associated with higher odds of completing residential treatment for both types of opioids but lower odds of completing detoxification and outpatient treatment. Treatment duration >30 days tended to have higher odds of completion. PO cases age 65+ had higher odds of completing residential treatment than cases age 55-64. Racial/ethnic minorities tended to have lower odds of outpatient treatment completion. Study findings underscore the importance of helping older adults complete treatment, especially those who are racial/ethnic minorities and receiving outpatient treatment.
在这项研究中，我们使用了 2015-2018 年治疗期数据集中的出院病例（TEDS-D），这些病例的年龄在 55 岁以上，主要使用海洛因（N=101,524）或处方类阿片（PO；N=25,510）。我们考察了治疗完成率和相关因素。我们分别为海洛因和 PO 病例拟合了逻辑回归模型，以每个治疗环境（解毒、住院康复和门诊）中的治疗完成情况（完成 vs. 因辍学/终止/其他原因而中断）为因变量。结果表明，解毒治疗的完成率最高，门诊治疗的完成率最低（海洛因病例为 14.8%，PO 病例为 24.0%）。海洛因病例的法律系统转介和 PO 病例的学士学位是治疗完成的一致显著相关因素。对于这两种阿片类药物，药物辅助治疗与更高的住院治疗完成几率相关，但与更高的解毒治疗和门诊治疗完成几率相关。治疗时间超过 30 天的患者完成治疗的几率更高。65 岁以上的 PO 病例完成住院治疗的几率高于 55-64 岁的病例。少数民族完成门诊治疗的几率较低。研究结果强调了帮助老年人完成治疗的重要性，尤其是那些少数民族和接受门诊治疗的老年人。
