Wenger L D, Rosenbaum M
Institute for Scientific Analysis, San Francisco, California 94110.
J Psychoactive Drugs. 1994 Jan-Mar;26(1):1-11. doi: 10.1080/02791072.1994.10472597.
Drug treatment on demand, appropriate and affordable drug treatment for injection drug users who are "ready" to enter a program, is a humane approach to drug treatment services and an important mechanism to halt the spread of HIV. However, drug treatment on demand is not a reality in the United States. In fact, due to funding cuts at federal, state, and local levels, entry into drug treatment programs has become increasingly more difficult over the past decade. In a NIDA-funded ethnographic study of methadone maintenance, i.v. drug use and AIDS, 70 heroin addicts who were out of treatment and actively seeking methadone maintenance were interviewed. In life-history interviews, the drug users described barriers to treatment, waiting-list experiences, and the impact of these experiences on their drug use, drug-using behavior, and emotional well-being. Respondents used many mechanisms to cope with the lack of availability of drug treatment slots, some of which have increased their risk of exposure to and spread of HIV. These findings indicate the need for an increase in the availability of subsidized methadone maintenance treatment slots "on demand" if individuals are to decrease their drug use and their high-risk behaviors. Drug treatment on demand is more than politically correct rhetoric. It is a necessary ingredient in reducing the harm caused by the use of illegal drugs.
按需提供药物治疗，即为那些“准备好”进入治疗项目的注射吸毒者提供适宜且可负担得起的药物治疗，这是一种人道的药物治疗服务方式，也是遏制艾滋病毒传播的一项重要机制。然而，在美国，按需提供药物治疗并非现实。事实上，由于联邦、州和地方各级的资金削减，在过去十年里，进入药物治疗项目变得越来越困难。在一项由美国国家药物滥用研究所资助的关于美沙酮维持治疗、静脉注射吸毒与艾滋病的人种志研究中，对70名已停止治疗并积极寻求美沙酮维持治疗的海洛因成瘾者进行了访谈。在生活史访谈中，吸毒者描述了治疗的障碍、等待名单上的经历，以及这些经历对他们吸毒、吸毒行为和情绪健康的影响。受访者采用了多种机制来应对药物治疗名额不足的问题，其中一些机制增加了他们接触和传播艾滋病毒的风险。这些研究结果表明，如果个人要减少吸毒及高危行为，就需要增加按需提供的补贴美沙酮维持治疗名额。按需提供药物治疗并非只是政治正确的言辞。它是减少非法药物使用造成危害的必要因素。
