McCusker J, Bigelow C, Luippold R, Zorn M, Lewis B F
Department of Clinical Epidemiology, Centre Hospitalier de St. Mary, Montreal, Quebec, Canada.
Am J Drug Alcohol Abuse. 1995 Feb;21(1):1-16. doi: 10.3109/00952999509095225.
We investigated the outcomes of a 21-day inpatient drug detoxification and rehabilitation program including length of stay, transfer to further treatment, and HIV risky behavior. Clients (n = 567) were predominantly White, male, currently unemployed, and their treatment was not covered by third party payment. 78% were detoxified with methadone. The median length of stay was 18 days. Higher education, not living with spouse or children, English as primary language, admission during fall or winter months, and greater knowledge of HIV transmission were independent predictors of greater length of stay. Among those with follow-up (n = 450), 19% were transferred to residential drug-free programs and 7% to outpatient programs. Taking into account loss to follow-up, the overall rate of treatment transfer could be as low as 21%. Greater length of stay was associated with higher rates of transfer to residential treatment. Relapse rates to either any drug use or injection drug use were lower among subjects transferred to residential treatment than either clients transferred to outpatient programs or those with no further treatment. Among subjects who continued to inject drugs at follow-up, no reduction in HIV risky behaviors was found regardless of further treatment. We conclude that detoxification programs have the potential for reducing relapse to drug use when followed by residential drug-free treatment.
我们调查了一个为期21天的住院药物戒毒与康复项目的结果，包括住院时间、转至进一步治疗的情况以及艾滋病病毒危险行为。服务对象（n = 567）主要为白人男性，目前处于失业状态，且其治疗费用没有第三方支付。78%的人使用美沙酮进行戒毒。住院时间的中位数为18天。受教育程度较高、不与配偶或子女同住、以英语作为主要语言、在秋冬季节入院以及对艾滋病病毒传播有更多了解是住院时间更长的独立预测因素。在有随访的对象（n = 450）中，19%的人转至无毒品的住院项目，7%的人转至门诊项目。考虑到失访情况，治疗转移的总体发生率可能低至21%。住院时间更长与转至住院治疗的比例更高相关。转至住院治疗的对象中，任何药物使用或注射吸毒的复发率低于转至门诊项目的对象或未接受进一步治疗的对象。在随访时继续注射毒品的对象中，无论是否接受进一步治疗，均未发现艾滋病病毒危险行为有所减少。我们得出结论，戒毒项目在后续进行无毒品住院治疗时有可能减少吸毒复发。
