Craddock S G, Rounds-Bryant J L, Flynn P M, Hubbard R L
Research Triangle Institute, Substance Abuse Treatment Research Program, Research Triangle Park, North Carolina 27709-2194, USA.
Am J Drug Alcohol Abuse. 1997 Feb;23(1):43-59. doi: 10.3109/00952999709001686.
This study summarizes historical changes among clients entering drug treatment in their sociodemographic characteristics and important pretreatment behaviors, such as work activity, criminal behavior, drug use, prior drug treatment, and health insurance. Data are drawn from three major studies of drug abuse treatment clients: the Drug Abuse Reporting Program (DARP), 1969-1972; the Treatment Outcome Prospective Study (TOPS), 1979-1981; and the Drug Abuse Treatment Outcome Study (DATOS), 1991-1993. The mix of drug treatment clients and their interaction with the drug treatment system changed substantially over the past three decades. Because data items are most directly comparable between TOPS and DATOS, the focus of this paper is on changes within the past decade. The most conspicuous change is in types and numbers of drugs used by clients entering treatment. Multiple drug use declined since the late 1970s, while reports of cocaine use since TOPS more than doubled among clients in the long-term residential and outpatient treatment modalities, and increased 1 1/2 times among methadone clients. Other differences in treatment populations include decreases in clients' working full-time and in reports of suicidal ideation and attempts and predatory crime. Data from such studies as DARP, TOPS, and DATOS are valuable in historical, contextual, policy, and evaluative frameworks. The changing nature of the drug treatment client population--from sociodemographics to drug use and multiple treatment problem severities--highlights the complexity of issues and difficulties encountered by those attempting to treat clients or plan treatment strategies.
本研究总结了进入药物治疗的患者在社会人口统计学特征以及重要的治疗前行为方面的历史变化，这些行为包括工作活动、犯罪行为、药物使用、既往药物治疗以及医疗保险情况。数据来源于三项关于药物滥用治疗患者的主要研究：1969 - 1972年的药物滥用报告项目（DARP）；1979 - 1981年的治疗结果前瞻性研究（TOPS）；以及1991 - 1993年的药物滥用治疗结果研究（DATOS）。在过去三十年中，药物治疗患者的构成及其与药物治疗系统的相互作用发生了显著变化。由于TOPS和DATOS之间的数据项具有最强的直接可比性，本文重点关注过去十年内的变化。最显著的变化在于进入治疗的患者所使用药物的类型和数量。自20世纪70年代末以来，多种药物滥用情况有所下降，而自TOPS研究以来，长期住院和门诊治疗模式下的患者中可卡因使用报告增加了一倍多，美沙酮治疗患者中的这一报告增加了1.5倍。治疗人群的其他差异包括全职工作的患者减少，自杀意念、自杀未遂及掠夺性犯罪的报告减少。来自DARP、TOPS和DATOS等研究的数据在历史、背景、政策和评估框架中具有重要价值。药物治疗患者群体性质的变化——从社会人口统计学特征到药物使用以及多种治疗问题的严重程度——凸显了试图治疗患者或制定治疗策略的人员所面临问题的复杂性和困难程度。
