Cacciola J S, Alterman A I, Rutherford M J, McKay J R, McLellan A T
PENN-VA Center for Studies of Addiction, Philadelphia Veterans Affairs Medical Center, PA, USA.
Addiction. 1998 Jan;93(1):41-9. doi: 10.1046/j.1360-0443.1998.931415.x.
This study examined the functional and substance use status of methadone maintenance (MM) patients at treatment entry and 2 and 7 months later.
Two groups of subjects were identified for longitudinal follow-up, those in continuous MM treatment and those who left treatment.
The study was conducted at the Philadelphia Veterans Affairs Medical Center MM Program.
Subjects were 157 men admitted to treatment.
Change was evaluated using the Addiction Severity Index and urinalysis results.
Both groups of subjects reported significant reductions in drug use and increases in psychosocial functioning from admission to month 2, but demonstrated no significant changes from months 2 to 7. Subjects who left treatment, however, had more heroin use and criminal activity at all evaluation points than subjects who remained in treatment. Urinalysis data also suggested that subjects who left treatment were using drugs more frequently while in treatment than were those subjects who remained continuously enrolled in MM. Finally, subjects who left treatment spent more time in restricted environments (e.g. inpatient treatment, jail) at follow-up.
Services may need to be enhanced to foster continuing progress in patients who remain in MM treatment and to retain those patients with more severe problems who leave treatment early.
本研究调查了美沙酮维持治疗（MM）患者在治疗开始时、2个月后和7个月后的功能及物质使用状况。
确定两组受试者进行纵向随访，即持续接受MM治疗的患者和停止治疗的患者。
该研究在费城退伍军人事务医疗中心的MM项目中进行。
157名接受治疗的男性受试者。
使用成瘾严重程度指数和尿液分析结果评估变化情况。
两组受试者均报告从入院到第2个月药物使用显著减少，心理社会功能有所改善，但从第2个月到第7个月无显著变化。然而，在所有评估点，停止治疗的受试者比继续接受治疗的受试者有更多的海洛因使用和犯罪活动。尿液分析数据还表明，停止治疗的受试者在治疗期间比持续接受MM治疗的受试者更频繁地使用药物。最后，停止治疗的受试者在随访时在受限环境（如住院治疗、监狱）中花费的时间更多。
可能需要加强服务，以促进继续接受MM治疗的患者持续取得进展，并留住那些有更严重问题且过早停止治疗的患者。
