Fairbank J A, Dunteman G H, Condelli W S
Research Triangle Institute, Research Triangle Park, North Carolina 27709.
Am J Drug Alcohol Abuse. 1993;19(4):465-74. doi: 10.3109/00952999309001635.
Data were analyzed from the nationwide Treatment Outcome Prospective Study (TOPS) to assess whether current and former methadone patients substitute other drugs for heroin. The sample comprised 513 heroin users who were admitted to methadone programs in 10 cities across the United States and followed for at least 1 year. Structured face-to-face interviews were administered at admission and at follow-up to assess use of six substances: cocaine, amphetamines, illegal methadone, tranquilizers, marijuana, and alcohol. The study found a decline in the use of all substances except alcohol. Patients who substantially reduced or eliminated their use of heroin during the follow-up year were more likely to decrease their use of other drugs than were patients who continued to use heroin on a weekly or more frequent basis. These findings suggest that methadone programs indirectly reduce patients' use of cocaine, amphetamines, illegal methadone, tranquilizers, and marijuana, insofar as they are successful in eliminating or decreasing heroin use. Similar reductions in drug use were found among patients who were not enrolled in methadone programs during the follow-up year. These findings do not support the commonly held belief that heroin addicts substitute other drugs for heroin.
对全国性治疗结果前瞻性研究（TOPS）的数据进行了分析，以评估当前和以前的美沙酮患者是否会用其他药物替代海洛因。样本包括513名海洛因使用者，他们在美国10个城市的美沙酮项目中登记，并随访至少1年。在入院时和随访时进行结构化面对面访谈，以评估六种物质的使用情况：可卡因、苯丙胺、非法美沙酮、镇静剂、大麻和酒精。研究发现，除酒精外，所有物质的使用都有所下降。在随访年度内大幅减少或戒除海洛因使用的患者，比每周或更频繁使用海洛因的患者更有可能减少其他药物的使用。这些发现表明，美沙酮项目在成功消除或减少海洛因使用的程度上，间接减少了患者对可卡因、苯丙胺、非法美沙酮、镇静剂和大麻的使用。在随访年度未参加美沙酮项目的患者中也发现了类似的药物使用减少情况。这些发现不支持普遍持有的海洛因成瘾者用其他药物替代海洛因的观点。
