MacKenzie Nina, Smith Daniel J, Lawrie Stephen M, M Rome Andrew, McCartney David
Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; and NHS Lothian, Edinburgh, UK.
Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
BJPsych Open. 2023 Mar 13;9(2):e52. doi: 10.1192/bjo.2023.23.
Tackling Scotland's drug-related deaths and improving outcomes from substance misuse treatments, including residential rehabilitation, is a national priority.
To analyse and report outcomes up to 4 years after attendance at a substance misuse residential rehabilitation programme (Lothians and Edinburgh Abstinence Programme).
In total, 145 participants were recruited to this longitudinal quantitative cohort study of an abstinence-based residential rehabilitation programme based on the therapeutic community model; 87 of these participants were followed up at 4 years. Outcomes are reported for seven subsections of the Addiction Severity Index-X (ASI-X), together with frequency of alcohol use, heroin use, injecting drug use and rates of abstinence from substances of misuse.
Significant improvement in most outcomes at 4 years compared with admission scores were found. Completing the programme was associated with greater rates of abstinence, reduced alcohol use and improvements in alcohol status score (Mann-Whitney = 626, = 0.013), work satisfaction score ( = 596, = 0.016) and psychiatric status score ( = 562, = 0.007) on the ASI-X, in comparison with non-completion. Abstinence rates improved from 12% at baseline to 48% at 4 years, with the rate for those completing the programme increasing from 14.5% to 60.7% (χ(2, 87) = 9.738, = 0.002). Remaining abstinent from substances at follow-up was associated with better outcomes in the medical ( = 540, < 0.001), psychiatric ( = 273.5, < 0.001) and alcohol ( = 322.5, < 0.001) subsections of the ASI-X.
Attending this abstinence-based rehabilitation programme was associated with positive changes in psychological and social well-being and harm reduction from substance use at 4-year follow-up, with stability of change from years 1 to 4.
解决苏格兰与毒品相关的死亡问题并改善药物滥用治疗（包括住院康复治疗）的效果是一项国家优先事项。
分析并报告参加药物滥用住院康复项目（洛锡安和爱丁堡戒毒项目）后长达4年的治疗效果。
总共招募了145名参与者，对这个基于治疗社区模式的以戒毒为基础的住院康复项目进行纵向定量队列研究；其中87名参与者在4年后接受了随访。报告了成瘾严重程度指数-X（ASI-X）七个子部分的治疗效果，以及酒精使用频率、海洛因使用频率、注射吸毒频率和药物滥用戒除率。
与入院时的分数相比，4年后大多数治疗效果都有显著改善。与未完成项目的参与者相比，完成项目与更高的戒除率、减少酒精使用以及ASI-X上的酒精状况评分（Mann-Whitney = 626，P = 0.013）、工作满意度评分（P = 596，P = 0.016）和精神状况评分（P = 562，P = 0.007）的改善相关。戒除率从基线时的12%提高到4年时的48%，完成项目者的戒除率从14.5%提高到60.7%（χ(2, 87) = 9.738，P = 0.002）。随访时保持对药物的戒除与ASI-X的医疗（P = 540，P < 0.001）、精神（P = 273.5，P < 0.001）和酒精（P = 322.5，P < 0.001）子部分的更好治疗效果相关。
参加这个以戒毒为基础的康复项目与4年随访时心理和社会幸福感的积极变化以及药物使用危害的减少相关，且从第1年到第4年变化保持稳定。
