Klingemann K H, Efionayi-Mäder D
Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme, Lausanne.
Schweiz Rundsch Med Prax. 1994 Aug 23;83(34):937-49.
Referring to theoretical and empirical examples taken from psychiatry, psychology and sociology, this paper first clarifies the dimensions and application of concepts such as 'natural recovery' and 'spontaneous remission'. In order to illustrate the general development of research in the area of therapy free drug remission from a purely quantitative approach to a qualitative, ethnographic one, two studies are referred to: the classic Vietnam veteran study done by Robins and a longitudinal analysis of a network of cocaine users. This is also supplemented by the latest results from Germany. Next, the empirical results of the ongoing spontaneous remitter follow-up study from the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA) are presented. The analysis of the gender specific processes involved in the long-term stabilization of heroin autoremission, taking the support of social surroundings into consideration, shows the following: independent of gender, a high stability of autoremission was determined four years after the initial survey. In only three out of thirty cases has there been a relapse since the first interview. This result confirms the general significance of social support during the autoremission phase for both gender groups. Measured against dominant role expectations, it can be said that most of the men have successfully reintegrated into society. Women, on the other hand, seem to deviate more strongly from traditional professional and family roles. This might be due to particularly longlasting social sanctions during their former addiction. Finally, some practical consequences for the drug treatment system drawn from autoremission research are discussed as well as some drug and social policy conditions favorable to autoremission.
本文参考了精神病学、心理学和社会学领域的理论及实证案例，首先阐明了“自然康复”和“自发缓解”等概念的维度与应用。为说明从单纯的定量方法到定性的人种志方法，治疗性药物缓解领域研究的总体发展情况，本文引用了两项研究：罗宾斯所做的经典越战退伍军人研究以及对可卡因使用者网络的纵向分析。德国的最新研究成果也为此提供了补充。接下来，介绍了瑞士酒精和药物问题预防研究所（SIPA）正在进行的自发缓解者随访研究的实证结果。在考虑社会环境支持的情况下，对海洛因自动缓解长期稳定过程中涉及的性别特定过程进行分析后发现：与性别无关，在初次调查四年后确定自动缓解具有高度稳定性。自首次访谈以来，三十个案例中仅有三例出现复发。这一结果证实了自动缓解阶段社会支持对两个性别群体的普遍重要性。对照占主导地位的角色期望来看，可以说大多数男性已成功重新融入社会。另一方面，女性似乎更强烈地偏离了传统的职业和家庭角色。这可能是由于她们在以往成瘾期间受到了特别长期的社会制裁。最后，本文讨论了自动缓解研究对药物治疗系统产生的一些实际影响，以及有利于自动缓解的一些药物和社会政策条件。
