Tiljak H
Sveuciliste u Zagrebu, Medicinski fakultet, Skola narodnog zdravlja Andrija Stampar.
Lijec Vjesn. 1998 May;120(5):125-31.
In spite of the 30-year experience in the use of methadone in heroin addicts, there is no consensus about the value of that method. In view of the opinion that resistance to methadone treatment is partly caused by ignorance, the aim of this paper is to improve the knowledge about the method. The paper offers explanation of: (1) metabolic basis of heroin addiction, (2) methadone pharmacology, (3) psychosocial aspects of the addiction, (4) methadone treatment procedure, (5) aims and (6) results of the treatment. A demand for designing the treatment program on the basis of expert knowledge rather than on political and moral judgments is stressed. Topics in program organization are described: indications, daily dosage and its administration, treatment duration, professional job-sharing and control of the treatment. A review of medical goals--individual-oriented and social-oriented goals of the treatment is made. "Therapeutic milieu", as well as treatment dose and treatment duration have been recognized as the main determinants of the outcome. Evaluation criteria and treatment have been elaborated as potential basis for further research.
尽管在海洛因成瘾者中使用美沙酮已有30年的经验，但对于该方法的价值尚无共识。鉴于有人认为对美沙酮治疗的抵触部分是由无知引起的，本文旨在增进对该方法的了解。本文对以下内容进行了解释：（1）海洛因成瘾的代谢基础，（2）美沙酮药理学，（3）成瘾的社会心理方面，（4）美沙酮治疗程序，（5）治疗目标，以及（6）治疗结果。强调了基于专业知识而非政治和道德判断来设计治疗方案的必要性。描述了方案组织中的主题：适应症、每日剂量及其给药方式、治疗持续时间、专业分工以及治疗控制。对治疗的医学目标——以个体为导向和以社会为导向的目标进行了综述。“治疗环境”以及治疗剂量和治疗持续时间已被视为治疗结果的主要决定因素。评估标准和治疗方法已被详细阐述，作为进一步研究的潜在基础。
