Bucknall A B, Robertson J R
Fam Pract. 1985 Dec;2(4):244-51. doi: 10.1093/fampra/2.4.244.
Drug users are a heterogeneous group in terms of social class and background, personality, and patterns of drug use. They are often stereotyped by both the public and the health services and this can lead to obstruction of a successful doctor-patient relationship. The real problem lies not so much in detoxification but in the prevention of relapses and the maintenance of the patient in a drug-free condition. There has recently been a shift in emphasis away from drug treatment centres and hospital based treatment towards community care and family medicine. The role of the family practitioner is largely unexplored yet, rather than inspiring research, the increased contact between general practitioners and drug users has caused concern. This review concentrates on two related areas of study important for family practitioners in the management of drug misuse: the role of drug misuse in family membership and in parenthood. Families have been shown to play a role in the aetiology of drug abuse, but more important is their role in the maintenance of an individual's drug dependence. The family doctor is in an ideal position to recruit the family into the drug user's treatment. Although far fewer 'addicts' come to serious harm than is commonly believed, the risks extend also to the children born of narcotic dependent mothers. Family doctors, obstetricians and paediatricians must be aware of the particular problems for mother and child.
吸毒者在社会阶层、背景、个性以及吸毒模式等方面构成一个异质群体。他们常常受到公众和医疗服务机构的刻板印象影响，这可能会阻碍建立成功的医患关系。真正的问题不在于戒毒，而在于预防复吸以及使患者保持无毒品状态。最近，重点已从戒毒治疗中心和医院治疗转向社区护理和家庭医学。家庭医生的作用在很大程度上尚未得到充分探索，然而，全科医生与吸毒者之间增加的接触引发了担忧，而非激发研究。本综述着重于家庭医生在药物滥用管理中重要的两个相关研究领域：药物滥用在家庭成员关系和为人父母方面的作用。研究表明，家庭在药物滥用的病因学中发挥作用，但更重要的是它们在维持个人药物依赖方面的作用。家庭医生处于理想位置，可以让家庭参与吸毒者的治疗。尽管“瘾君子”受到严重伤害的人数远比普遍认为的要少，但风险也延伸到了依赖麻醉品的母亲所生的孩子身上。家庭医生、产科医生和儿科医生必须意识到母婴面临的特殊问题。
