Scott Russ
West Moreton Prison Mental Health Service, Brisbane, QLD, Australia.
Psychiatr Psychol Law. 2023 Jul 4;31(4):671-704. doi: 10.1080/13218719.2023.2206870. eCollection 2024.
Australia has one of the highest rates in the world of the use of the crystalline form of methamphetamine, a highly addictive stimulant that is often associated with a chronic, relapsing dependency. Methamphetamine use is associated with both acquisitive and violent offending, which cause substantial personal and societal costs. Whilst the short-term euphoria and stimulation provide a positive reinforcement to methamphetamine use, the aversive states of withdrawing from methamphetamine and the associated craving, which may last up to five weeks into abstinence, underlie the negative reinforcement to continued methamphetamine use. Although many methamphetamine-dependent users experience high levels of psychological distress, it is likely that less than half engage with treatment or support services, and current intervention and treatment programmes have high discontinuation rates. Stigma and discrimination, even from paramedics and health clinicians, are prominent barriers to methamphetamine-dependent users accessing treatment in Australia.
澳大利亚是世界上甲基苯丙胺晶体形式使用率最高的国家之一,甲基苯丙胺是一种极易上瘾的兴奋剂,通常与慢性复发性成瘾有关。使用甲基苯丙胺与 acquisitive犯罪和暴力犯罪都有关联,这会造成巨大的个人和社会成本。虽然短期内的欣快感和刺激会对甲基苯丙胺的使用起到正向强化作用,但戒断甲基苯丙胺时出现的厌恶状态以及随之而来的渴望,这种渴望在戒断后可能持续长达五周,是导致继续使用甲基苯丙胺的负向强化因素。尽管许多依赖甲基苯丙胺的使用者经历着高度的心理困扰,但可能只有不到一半的人会寻求治疗或支持服务,而且目前的干预和治疗项目中断率很高。在澳大利亚,即使是护理人员和健康临床医生的污名化和歧视,也是依赖甲基苯丙胺的使用者获得治疗的突出障碍。 (注:原文中“acquisitive”可能有误,推测可能是“acquisitive crime”,这里先按原文翻译)