Bell J, Mattick R, Hay A, Chan J, Hall W
Drug and Alcohol Unit, Prince of Wales Hospital, Randwick, NSW, Australia.
J Subst Abuse. 1997;9:15-25. doi: 10.1016/s0899-3289(97)90003-1.
Using data from an evaluation of methadone maintenance treatment, this study investigated factors associated with continued involvement in crime during treatment, and in particular whether there appeared to be differences in effectiveness of treatment between different methadone clinics. The methodology was an observational study, in which 304 patients attending three low-intervention, private methadone clinics in Sydney were interviewed on three occasions over a twelve month period. Outcome measures were self-reported criminal activity and police department records of convictions. By self-report, crime dropped promptly and substantially on entry to treatment, to a level of acquisitive crime about one-eighth that reported during the last addiction period. Analysis of official records indicated that rates of acquisitive convictions were significantly lower in the in-treatment period compared to prior to entry to treatment, corroborating the changes suggested by self-report. Persisting involvement in crime in treatment was predicted by two factors: the cost of persisting use of illicit drugs, particularly cannabis, and ASPD symptom count. Treatment factors also were independently predictive of continued involvement in crime. By both self-report and official records, and adjusting for subject factors, treatment at one clinic was associated with greater involvement in crime. This clinic operated in a chaotic and poorly organized way. It is concluded that crime during methadone treatment is substantially lower than during street addiction, although the extent of reduction depends on the quality of treatment being delivered.
本研究利用美沙酮维持治疗评估的数据，调查了与治疗期间持续犯罪相关的因素，特别是不同美沙酮诊所之间的治疗效果是否存在差异。研究方法为观察性研究，在12个月内对悉尼3家低干预的私立美沙酮诊所的304名患者进行了3次访谈。结果指标为自我报告的犯罪活动和警方的定罪记录。通过自我报告，进入治疗后犯罪率迅速大幅下降，达到财产犯罪水平约为上一个成瘾期报告水平的八分之一。官方记录分析表明，与进入治疗前相比，治疗期间财产犯罪定罪率显著降低，证实了自我报告所显示的变化。持续参与治疗期间犯罪可由两个因素预测：持续使用非法药物（尤其是大麻）的成本以及反社会人格障碍症状数量。治疗因素也可独立预测持续参与犯罪。通过自我报告和官方记录，并对个体因素进行调整后发现，在一家诊所接受治疗与更多地参与犯罪有关。这家诊所运营混乱且组织不善。研究得出结论，美沙酮治疗期间的犯罪率大幅低于街头成瘾期间，尽管降低程度取决于所提供治疗的质量。
