Belding M A, McLellan A T, Zanis D A, Incmikoski R
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, USA.
J Subst Abuse Treat. 1998 Nov-Dec;15(6):485-92. doi: 10.1016/s0740-5472(97)00292-4.
A review of records at a large urban methadone clinic revealed a substantial group of patients with treatment tenures of at least 6 months whose urinalysis results indicated continued regular use of opiates. In an attempt to characterize these "nonresponsive" patients and to identify their specific treatment needs, we compared them to a group of patients with comparable treatment tenures but whose urinalysis results indicated little or no recent illicit opiate use. Contrary to expectations, opiate use itself was virtually the only feature that clearly distinguished the two groups. "Responders" and "nonresponders" did not differ significantly on measures of psychosocial problem severity in any other area, nor did they differ in their treatment service utilization. Moreover, examination of admission data indicated that the two groups showed similar rates of improvement in the severity of their psychosocial problems in all seven measured areas. The implications of these results for treatment and clinic administration are discussed.
对一家大型城市美沙酮诊所的记录进行审查后发现，有相当一部分患者的治疗期至少为6个月，但其尿液分析结果显示仍在定期使用阿片类药物。为了描述这些“无反应”患者的特征并确定他们的具体治疗需求，我们将他们与一组治疗期相当但尿液分析结果显示近期很少或没有非法使用阿片类药物的患者进行了比较。与预期相反，阿片类药物的使用本身几乎是唯一能明确区分这两组患者的特征。“有反应者”和“无反应者”在任何其他领域的心理社会问题严重程度指标上没有显著差异，他们在治疗服务利用方面也没有差异。此外，对入院数据的检查表明，两组患者在所有七个测量领域的心理社会问题严重程度的改善率相似。本文讨论了这些结果对治疗和诊所管理的影响。
