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老挝的鸦片和海洛因成瘾者。二、配对研究

Opium and heroin addicts in Laos. II. A study of matched pairs.

作者信息

Westermeyer J, Peng G

出版信息

J Nerv Ment Dis. 1977 May;164(5):351-4. doi: 10.1097/00005053-197705000-00007.

Abstract

Fifty-one Asian heroin addicts in Laos were matched for sex, ethnicity, and age with 51 opium addicts. All subjects were voluntary patients at a treatment facility for addicts. The two groups were compared for demographic characteristics, past narcotic history, current narcotic use, and readmission within 1 year following discharge from treatment. Heroin addicts took more doses of drug per day, spent more money per day on narcotic drugs, required higher detoxification doses of methadone, and sought treatment much sooner than did opium addicts. The two groups did not differ for duration of narcotic use prior to becoming addicted, or for rate of readmission following treatment. Demographic differences in occupation and employment reflected the urban distribution of heroin addicts, and the mixed urban-rural residence of opium addicts. These data suggest that heroin is not per se more or less apt to produce addiction (i.e., is not more "addictogenic") as compared to opium. The type of narcotic drug also does not appear to be an important factor in determining treatment outcome. However, heroin does appear to be more "pathogenic" than opium, since heroin addicts sought treatment much sooner than did opium addicts. This may have been due to economic factors (i. e., heroin addicts took more doses per day, spent more time in phases of intoxication and withdrawal, and spent less time in the middle phase with work and other coping behaviors). Opium addiction is not a "benign" or "social" form of addiction. In comparison to heroin, however, opium does cost less, requires fewer doses per day, and has a less toxic withdrawal (at least in the initial phase). Moreover, opium apparently takes longer to produce life crises that motivate the addict to seek treatment.

摘要

在老挝,51名亚洲海洛因成瘾者与51名鸦片成瘾者在性别、种族和年龄上进行了匹配。所有受试者均为一家成瘾治疗机构的自愿患者。对两组患者的人口统计学特征、既往吸毒史、当前吸毒情况以及治疗出院后1年内的再次入院情况进行了比较。海洛因成瘾者每天服用的毒品剂量更多,每天在毒品上花费的钱更多,美沙酮脱毒剂量要求更高,且比鸦片成瘾者更早寻求治疗。两组在成瘾前的吸毒持续时间或治疗后的再次入院率方面没有差异。职业和就业方面的人口统计学差异反映了海洛因成瘾者的城市分布情况以及鸦片成瘾者城乡混合居住的情况。这些数据表明,与鸦片相比,海洛因本身并不更易或更不易导致成瘾(即并非更具“成瘾性”)。毒品类型似乎也不是决定治疗结果的重要因素。然而,海洛因似乎比鸦片更具“致病性”,因为海洛因成瘾者比鸦片成瘾者更早寻求治疗。这可能是由于经济因素(即海洛因成瘾者每天服用的剂量更多,在中毒和戒断阶段花费的时间更多,而在有工作和其他应对行为的中间阶段花费的时间更少)。鸦片成瘾并非一种“良性”或“社会性”成瘾形式。然而,与海洛因相比,鸦片成本更低,每天所需剂量更少,戒断毒性也更小(至少在初始阶段)。此外,鸦片显然需要更长时间才会引发促使成瘾者寻求治疗的生活危机。

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