Brewer D D, Catalano R F, Haggerty K, Gainey R R, Fleming C B
Alcohol and Drug Abuse Institute, University of Washington, Seattle 98195, USA.
Addiction. 1998 Jan;93(1):73-92.
Many people treated for opiate addiction continue to use drugs during and after treatment. It may be possible to improve outcomes by addressing patient characteristics that predict continued drug use. This review uses meta-analytic techniques to identify risk factors for continued drug use in patients treated for opiate abuse.
A thorough search of the published literature yielded 69 studies that reported information on the bivariate association between one or more independent variables and continued use of illicit drugs during and after treatment for opiate addiction.
Most of the patient variables summarized have weak longitudinal relationships with continued drug use, although several variables display moderate longitudinal associations. Ten variables show statistically significant and longitudinally predictive relationships (average r > 0.1) with continued use, including: high level of pretreatment opiate/drug use, prior treatment for opiate addiction, no prior abstinence from opiates, abstinence from/light use of alcohol, depression, high stress, unemployment/employment problems, association with substance abusing peers, short length of treatment, and leaving treatment prior to completion. Several other variables may be potentially longitudinally predictive.
To prevent relapse, treatment interventions should address multiple variables because no single variable strongly predicts continued drug use.
许多接受阿片类药物成瘾治疗的人在治疗期间及之后仍继续使用毒品。通过解决那些预示着会持续吸毒的患者特征，或许有可能改善治疗效果。本综述采用荟萃分析技术来确定接受阿片类药物滥用治疗的患者持续吸毒的风险因素。
对已发表文献进行全面检索，得到69项研究，这些研究报告了一个或多个自变量与阿片类药物成瘾治疗期间及之后非法药物持续使用之间的双变量关联信息。
总结出的大多数患者变量与持续吸毒的纵向关系较弱，不过有几个变量显示出中等程度的纵向关联。有十个变量与持续使用存在统计学上显著的纵向预测关系（平均r>0.1），包括：治疗前阿片类药物/毒品使用量高、曾接受过阿片类药物成瘾治疗、之前未戒除阿片类药物、戒酒/少量饮酒、抑郁、高压力、失业/就业问题、与滥用药物的同伴交往、治疗时间短以及未完成治疗就离开。其他几个变量可能也具有潜在的纵向预测作用。
为防止复发，治疗干预应针对多个变量，因为没有单一变量能有力地预测持续吸毒情况。
