Duke University School of Medicine Department of Population Health Sciences, Durham, North Carolina, United States; University of North Carolina at Chapel Hill, United States.
University of North Carolina at Chapel Hill, United States.
J Subst Use Addict Treat. 2024 Dec;167:209490. doi: 10.1016/j.josat.2024.209490. Epub 2024 Aug 22.
People who inject drugs (PWID) experience high rates of mental health problems and drug-related harms. Harm reduction-focused interventions aim to reduce harms associated with drug use and are an important approach for engaging people who are not seeking traditional abstinence-focused treatment. Yet, few studies to date have examined the effectiveness of harm reduction psychosocial treatment for drug use. We evaluated the outcomes of a harm reduction-focused behavioral activation (BA) intervention from pretreatment to a 1-month follow-up.
A total of N = 23 PWID (65.2 % White; 52.2 % women; mean age 35.4 ± 7.8 years) were recruited from syringe services programs and n = 19 received the intervention via teletherapy. Assessment of study outcome measures occurred at pre- and posttreatment and a one-month follow-up.
Results reflected post-intervention increases in behavioral activation and readiness to change drug use, as well as decreases in substance use, depression, and HIV risk behaviors. There were mixed outcomes on substance-related problems with increases at follow-up, possibly reflecting increased problem recognition.
These results suggest initial promise for the harm reduction-focused treatment. Additional research with randomized designs and larger sample sizes is needed, and more intensive treatment may be required to support sustained treatment gains in this population.
注射毒品者（PWID）经历着高比率的心理健康问题和与毒品相关的伤害。以减少伤害为重点的干预措施旨在减少与毒品使用相关的伤害，是一种吸引那些不寻求传统以戒除毒瘾为重点的治疗的重要方法。然而，迄今为止，很少有研究检验过以减少伤害为重点的心理社会干预对药物使用的有效性。我们评估了从治疗前到 1 个月随访期间，以减少伤害为重点的行为激活（BA）干预的结果。
共有 23 名 PWID（65.2%为白人；52.2%为女性；平均年龄 35.4±7.8 岁）从注射服务计划中招募而来，n=19 通过远程治疗接受了干预。在治疗前、治疗后和 1 个月随访期间评估了研究结果测量。
结果反映了治疗后的行为激活和改变药物使用的准备度增加，以及物质使用、抑郁和 HIV 风险行为减少。在物质相关问题上的结果存在混合情况，在随访时有所增加，可能反映了问题识别的增加。
这些结果表明，以减少伤害为重点的治疗有初步的前景。需要更多的随机设计和更大样本量的研究，并且可能需要更密集的治疗来支持该人群中持续的治疗收益。
