Maddux J F, Desmond D P, Esquivel M
Department of Psychiatry, University of Texas Health Science Center at San Antonio 78284-7792, USA.
Am J Drug Alcohol Abuse. 1995 Nov;21(4):533-47. doi: 10.3109/00952999509002714.
An open clinical trial was conducted to compare the effects of rapid (1-day) admission with slow (14-day) admission to methadone maintenance on pretreatment attrition, retention during treatment, and other outcomes. One hundred eighty-six illicit opioid users eligible for methadone maintenance were randomly assigned to rapid admission or slow admission, with 93 subjects assigned to each group. The random assignment produced two groups that were similar on 22 personal variables. All subjects admitted to treatment were followed for 1 year. Follow-up interviews were obtained with 155 (98%) of the 158 subjects admitted to treatment. During the period from initial contact to medication, only 4% of the rapid admission subjects but 26% of the slow admission subjects dropped out. The risk of dropout during slow admission was 6 times that during rapid admission. A higher percentage of rapid admission subjects, 43%, than of slow admission subjects, 39%, remained continuously in treatment for 1 year, but the difference was not significant. The two subgroups that remained in treatment for 1 year did about equally well on measures of illicit drug use and social performance. The findings indicate that pretreatment attrition can be markedly reduced by prompt medication, and the prompt medication does not adversely affect retention during treatment or other outcomes.
开展了一项开放性临床试验，以比较美沙酮维持治疗中快速（1天）入院与缓慢（14天）入院对治疗前脱落率、治疗期间留存率及其他结果的影响。186名符合美沙酮维持治疗条件的非法阿片类药物使用者被随机分配至快速入院组或缓慢入院组，每组93名受试者。随机分组产生的两组在22项个人变量上相似。所有入院治疗的受试者均随访1年。对158名入院治疗的受试者中的155名（98%）进行了随访访谈。从初次接触到用药期间，快速入院组仅有4%的受试者退出，但缓慢入院组有26%的受试者退出。缓慢入院期间的退出风险是快速入院期间的6倍。持续接受治疗1年的快速入院组受试者比例（43%）高于缓慢入院组受试者比例（39%），但差异不显著。持续接受治疗1年的两个亚组在非法药物使用和社会表现指标方面表现相当。研究结果表明，及时用药可显著降低治疗前脱落率，且及时用药不会对治疗期间的留存率或其他结果产生不利影响。
