McCusker J, Bigelow C, Frost R, Garfield F, Hindin R, Vickers-Lahti M, Lewis B
School of Public Health, University of Massachusetts, Amherst, USA.
Am J Public Health. 1997 Oct;87(10):1637-44. doi: 10.2105/ajph.87.10.1637.
This study assessed the effects of planned duration of residential drug abuse treatment on recovery from drug use and on human immunodeficiency virus (HIV) risk behaviors.
Two concurrent randomized controlled trials of programs differing in planned duration were conducted: 6-month vs 12-month versions of a traditional therapeutic community program, and 3-month vs 6-month versions of a modified therapeutic community incorporating a relapse prevention and health education program. Outcomes, measured at least 16.5 months after admission, included time from admission to first drug use; severity of drug, alcohol, legal, and employment problems; and risky drug injection and sexual behaviors.
Among 539 clients (86% of those enrolled), there were no significant effects of planned duration of treatment upon Addiction Severity Index scores or HIV risk behavior. In the relapse prevention program, clients randomized to the 6-month program had a longer time to first drug use than those in the 3-month program (hazard ratio = 0.74; 95% confidence interval = 0.58, 0.93). Employment problems at follow-up were significantly less severe among clients treated in the therapeutic community than among those in the relapse prevention program.
No overall benefit of extending treatment beyond 6 months was found.
本研究评估了住院药物滥用治疗的计划时长对戒毒康复及人类免疫缺陷病毒(HIV)风险行为的影响。
开展了两项关于计划时长不同的项目的同期随机对照试验:传统治疗社区项目的6个月版本与12个月版本,以及纳入复发预防和健康教育项目的改良治疗社区的3个月版本与6个月版本。入院至少16.5个月后测量的结果包括从入院到首次吸毒的时间;药物、酒精、法律和就业问题的严重程度;以及危险的药物注射和性行为。
在539名客户(占登记人数的86%)中,治疗计划时长对成瘾严重程度指数评分或HIV风险行为没有显著影响。在复发预防项目中,随机分配到6个月项目的客户首次吸毒的时间比3个月项目的客户长(风险比=0.74;95%置信区间=0.58,0.93)。治疗社区治疗的客户随访时的就业问题严重程度明显低于复发预防项目中的客户。
未发现治疗超过6个月有总体益处。