家属配合帮教的心理行为与患者脱毒后操守时间的关系

目的:通过改变吸毒人员家属配合帮教的心理行为延长脱毒人员的操守时间,提高预防复吸的效果,探索预防复吸的综合干预模式。方法:采用整群抽样和自愿纳入的原则选取干预组脱毒人员,同时,选择相同戒毒所不同楼层的脱毒人员作为对照组。对脱毒人员进行院内干预和对其家属进行院外干预,通过量表和自制问卷方式对结果进行调查,采用EpiData录入数据,SPSS12.0软件包进行数据分析。结果:干预组共有53人,失访率为7.55%;对照组为51人,失访率为15.69%。干预组半年操守率为24.49%,操守时间为83.92±53.14天,对照组戒毒人员的半年操守率为9.30%,操守时间为71.79±53.41天,经过统计学检验,两组无显著性差异(p>0.05);经过Cox生存分析,家属的信心、态度和行为支持是操守时间的影响因素。结论:家属的心理行为对戒毒人员脱毒后的操守时间有直接的影响,通过对吸毒人员家属进行综合形式的干预可以改善家属的焦虑症状,提高吸毒人员脱毒后的操守时间。     

38例女性戒毒人员院内心理综合干预的半年操守情况分析

目的:探索较为有效的综合性的院内心理干预方法,以降低女性戒毒人员的复吸率和延长其操守时间。方法:采取授课、心理训练和疏导等方式,运用认知疗法、脱敏疗法、放松训练、心理疏导等方法进行心理干预。结果:干预出院后38例中13例半年内未复吸、12例已复吸、13例失访,半年复吸率在31 .6 % - 6 5 . 8%之间,且本次干预后的操守时间比干预前一次显著延长(P <0. 0 1)。结论:运用心理综合干预措施对院内女性戒毒者进行干预可降低其半年复吸率和延长操守时间。     

复吸预防的综合干预措施对吸毒患者焦虑症状的疗效评价

目的:促进吸毒者戒毒后的身心康复,减缓吸毒者的焦虑症状,提高操守率、延长操守时间.方法:对干预组实施一个月的综合干预,内容包括:讲授与讨论毒品的有关知识、成功防复吸的要素、自我暗示和自我激励、心理脱敏和集体讨论等.干预前后分别对干预组和对照组进行焦虑症状调查.结果:干预前后干预组SAS平均得分差值明显高于对照组(P=0.0220,＜0.05).结论:该综合干预方案能够有效降低吸毒者的焦虑症状,加速脱毒病人的身心康复,对预防脱毒后复吸有一定的意义.     

动机-技能-脱敏-心理能量干预模式对海洛因依赖者戒毒后2年的随访研究

目的:评价动机-技能-脱敏-心理能量模式对戒毒人员中期操守率的影响。方法:选取襄阳市强制隔离獉獉獉獉戒毒所98名男性戒毒人员,随机分为试验组(49人)和对照组(49人),试验组接受动机-技能-脱敏-心理能量干预模式和常规戒毒教育,对照组只接受常规戒毒教育。在两组人员出所后进行电话随访,评价其出所满6个月、1年、2年后的操守情况。结果:出所后6个月、1年、2年随访,试验组操守人数(率)分别为25(54.30%)、18獉獉(39.13%)和10(21.74%);对照组操守人数(率)分别为4(9.30%)、4(9.30%)和2(4.65%),试验组操守人数(率)均高于对照组(P值均<0.05)。多元Logistic回归分析显示,接受心理干预(OR=6.192,95%CI:1.228-31.231)是戒毒人员保持2年操守的保护因素。结论:动机-技能-脱敏-心理能量干预模式可促进戒毒人员中獉獉期预防复吸和保持操守。     

动机-技能-脱敏-心理能量干预模式对海洛因依赖者戒毒后操守率的影响

目的獉獉:评价动机-技能-脱敏-心理能量模式对戒毒人员短期操守率的影响。方法獉獉:选取襄阳市强制隔离戒毒所男性戒毒人员98名,随机分为试验组和对照组,试验组接受动机-技能-脱敏-心理能量模式和戒毒所常规戒毒教育,对照组接受戒毒所常规戒毒教育。对试验组46人以及对照组43人,在其出所后进行电话随访,评价两组人员出所满1个月、3个月和6个月的操守情况。结果獉獉:试验组出所满1个月、3个月和6个月时,操守人数(率)分别是33(71.74%)、24(52.17%)和19(41.30%);对照组操守人数(率)分别是8(18.60%)、3(6.98%)和1(2.33%)。试验组操守率均远高于对照组(P<0.001)。多元Logistic回归结果显示,6个月随访结果中只有干预因素是患者操守的重要影响因素(OR值大于20,P均<0.01)。结论獉獉:本研究结果提示,动机-技能-脱敏-心理能量干预模式可促进戒毒患者保持操守。     

海洛因依赖者戒毒期间心理干预对焦虑症状的疗效观察

对112例烫吸海洛因成瘾者进行焦虑自评量表(SAS)评定,结果表明:海洛因依赖者存在明显的焦虑情绪[1],而焦虑情绪往往是导致药物滥用者复吸的一个重要原因之一.在戒毒过程中,除做好戒断症状护理外,及时做好焦虑症状的心理干预与护理,消除或缓解患者的焦虑抑郁状态,对促进戒毒成功,延长操守时间、促进身心康复是至关重要的.本文对观察组68例海洛因依赖者实施系统的抗焦虑治疗的基础上进行心理干预与护理,在加速戒毒成功,缓解焦虑症状、延长操守时间及减少复吸,促进身心康复与对照组比较收效显著.     

408名社区吸毒人员操守保持的相关因素分析

目的:正确推断社区吸毒解教人员操守保持的相关因素,为制定有效的戒毒政策提供科学依据。方法:以408名长沙市芙蓉区登记在册的操守保持者为研究对象,96名复吸者为对照,比较两组吸毒解教人员的人口学、吸毒和社区帮教相关情况的差异,并进行Logistic逐步回归分析。结果:操守保持者与复吸组比较,平均年龄、首次吸毒年龄相对较大,吸毒时间相对较短,曾经使用过毒品的种类和方式相对较少,戒毒次数相对较少;而操守保持者的社会帮教率(95·6%)明显高于复吸者(53·1%),平均每年尿液毒品检测次数相对较多,低保申请率和就业安置率相对较高。多因素分析结果表明劳教戒毒次数、就业安置和年尿液检测次数是影响操守成败的主要因素。结论:社区帮教措施能够促进社区吸毒解教人员保持操守,是戒毒所戒毒工作的延续和宏观戒毒管理的一个重要方面。     

脱毒治疗后复吸危险因素的Cox回归分析

目的··:探讨毒品复吸的危险因素 ,为制定其防治对策和措施提供科学依据。方法··:以110例脱毒治疗成功者为研究对象 ,随访观察6个月。应用SPSS10.0软件包做Cox回归分析 ,分析影响复吸的主要危险因素 ,并计算其生存及复吸危险函数。结果··:6个月累计复吸率为82.7%。就业状况、毒品心理依赖、家庭冷落、结交新朋友、毒品易获得是影响复吸的主要因素 ,相对危险度分别为0.566、2.045、2.017、0.380和3.168。复吸危险函数随时间延长而增加 ,而生存函数则与此相反。结论 :·· 毒品心理依赖、家庭冷落、毒品易获得是复吸的主要危险因素 ,而有正当职业、交结新朋友可降低复吸的危险。要巩固脱毒效果 ,使之真正回归社会 ,必须家庭、社会共同参与 ,综合治理 ,最大限度降低复吸的危险因素。     

518例阿片类依赖者复吸原因分析

目的:了解阿片类依赖者脱毒后的复吸情况及原因,以提高戒毒的操守率.方法:采用<复吸原因调查表>调查518例阿片类依赖者脱毒后复吸的情况.结果:在518例被调查者中,复吸者486人,复吸率为93.4%,平均复吸次数为4.56±2.13.复吸原因:稽延性戒断症状是产生复吸的主要身体原因(占60.2%);为解除心情烦恼(占65.3%),打发无聊时间(占56.2%),再吸"最后一次"(占58.1%),是产生复吸的主要心理原因;戒毒后回归旧环境,触景生情(占53.3%),受毒友的影响(占61.8%)开始复吸,是产生复吸的主要社会原因;另外,吸毒者戒毒信心不足(45.0%以上),使不少吸毒者不能保持操守.身体、心理、社会因子对复吸的影响差异显著(F=6.36,P＜0.01),经配对相关t检验,身体、心理因子对复吸的影响起决定作用.结论:选用合适的戒毒药品和在身体脱毒后进行心理康复是降低复吸率的必要手段.另外,政府的政策是控制吸毒的重要保证.     

纠正肝功能异常对海洛因依赖患者复吸的影响

目的:观察海洛因依赖者在进行脱毒治疗的同时纠正肝功能失调,对出院后保持操守的影响。方法:将40名肝功能异常的海洛因依赖患者随机分成二组,各20名,对照组只进行单纯脱毒治疗,另一组在脱毒治疗的同时,进行降酶、护肝、抗病毒、对症治疗。两组病人临床脱毒出院后坚持上门随访半年。结果:治疗组有15人操守1个月,11人操守两个月,9人操守3个月,5人操守4个月,2人操守5个月,1人操守半年,未治疗组8人操守1个月,5人操守2个月,2人操守3个月,1人操守4个月,没有人能操守5～6个月。二组病人的前6个月操守有显著性差异(P<0.01)。结论:纠正海洛因依赖者肝功能的异常可延缓复吸,保持较长时间的操守。     

戒毒人员的戒毒与操守

目的:了解戒毒人员的戒毒和操守状况。方法:自行设计“戒毒情况调查表”,对997例在所劳教戒毒人员进行调查。结果:被调查者既往经过反复自愿、强制、劳教戒毒的分别为566例(56·77%),941例,(94·38%)和708例(71·01%),其中504例曾戒毒3次以上。戒毒后操守时间最长不足0·3a者278例(27·88%),不足1a者469例(47·04%),2a以上只有48例(4·81%)。戒毒后复吸的主要原因有“无聊无事”,“想再尝试一口”,“毒友诱惑”,“感受到歧视、自卑”,“稽延性戒断症状”等。有844例认为,出所后有50%以上复吸的可能性。戒毒出所后最需要的是“家庭、社会的理解和支持”(544例,占54·56%)。结论:大部分患者经历多次反复戒毒,未能彻底戒除毒瘾。影响操守的原因很多。提示单纯戒毒不能降低复吸率,应该把心理辅导、社会和家庭支持有机纳入整个戒毒过程中,才能延长操守,降低复吸率。     

吸毒人员戒毒效果的社会心理影响因素

目的 :了解吸毒人群社会心理状况 ,分析影响戒毒效果的社会心理因素。方法 :对武汉市公安局强制戒毒所 6 16名吸毒人员进行社会心理因素和吸毒情况的系统调查。结果 :影响戒毒效果的因素有 :毒龄、初次吸毒年龄、心理渴求、负性情绪、情绪管理能力、消极应对、社会支持度等。结论 :社会心理因素影响吸毒人员的戒毒效果 ,导致吸毒行为的继续发展     

从绘画中看药物滥用者人际关系的损害

目的:通过"我和我的朋友"这一主题绘画的方式探讨药物滥用者在人际关系中存在的问题。方法:24名海洛因滥用者参加了本研究,年龄34.4a±s6.0a,男16人,女8人。每人画一张画,题目为"我和我的朋友"。分析方法为现象学描述。结果:对绘画分析的结果显示,91.7%患者的绘画显示他们没有与人建立真正的朋友关系。结论:患者的朋友关系都存在着实质性的损害,而朋友作为一种重要的社会支持又是吸毒患者康复中非常重要的一环,这种人际关系的修复可能是未来干预不可忽视的一个方面。     

Self-reported time-to-relapse following smoking cessation: Comparison by operationalization of initial abstinence classification

Aims: Relapse rates among cigarette smokers are high. Few studies have examined time-to-relapse using survival analysis in racially/ethnically diverse smokers and initial abstinence criteria have been inconsistent or unspecified. This study compared survival curves using two common definitions of initial abstinence. We hypothesized greater relapse rates among participants abstinent for only 24 hours (h) at the end-of-therapy (EOT) compared with 7 days. Methods: Adult smokers (59% Black, 22% Hispanic and 17% White) received 8-sessions of group cognitive behavioural therapy (CBT) plus transdermal nicotine patches and were assessed monthly up to 12 months post-EOT. Participants reporting abstinence (7-day point prevalence abstinence [ppa] or 24-h ppa) at the EOT were included in Kaplan–Meier curves. Results: Of 301 participants, 120 (40%) reported 7-day ppa at the EOT and an additional 29 (10%) reported 24-h ppa only. Over the 12-month follow-up period, nearly 50% remained abstinent. Of those who resumed smoking, most relapses occurred within the first three months. Survival curves indicated that median survival was 207 and 225 days for 7-day and 24-h definitions of abstinence, respectively. The difference in time-to-relapse between participants abstinent for 24?h at the EOT versus 7-days was not significant (p?=?0.14). Conclusions: Operationalization of initial abstinence is important for relapse analyses and comparisons of survival curves across samples. Participants reported high rates of abstinence and relapse rates were relatively low. Contrary to expectations, 24-h ppa at the EOT was not associated with greater relapse than 7-day abstinence. This suggests either measure may be utilized in relapse prevention research in racially/ethnically diverse treatment-seekers.     

Study on risk factors of suicidal ideation in people with drug abuse

In Japan, the target mental disorders of preventive strategies for suicide had been limited to be mood disorder, but recently drug abuse are known to be significant as a cause of suicide because some researches has found the association between substance use disorder and suicidal behavior in Japan. However, the preventive plans for suicide of drug abusers has not been developed yet. In this study we would like to examine the risk factors of suicide ideation in Japanese drug abusers. We analyzed the data of 445 drug addicts from the Nationwide Research of Drug Addiction Rehabilitation Centers by Tokyo DARC and compared many variables including demographic factors, drug use status, family history, psychopathologies, treatment and daily life satisfactions between people with suicide ideations and without ideations. It was found that 182 cases (43.8%) had suicide ideations in a recent month, and that addicts who had suicide ideations had significantly shorter abstinence time, higher prevalence of victimized experiences before 15 years age, and more mental symptoms such as insomnia, depression, and psychotic symptoms, and more tendencies to use prescribed psychotropic drug than those without suicide ideation. These results suggested that to prevent suicide of drug abusers, we should pay attention to family histories, insomnia and abstinence periods, and help them recovery from psychological damages caused by childhood trauma without inappropriate medications.     

Contingency management for behavior change: applications to promote brief smoking cessation among opioid-maintained patients

Cigarette smoking is highly prevalent among patients who are being treated for opioid-dependence, yet there have been limited scientific efforts to promote smoking cessation in this population. Contingency management (CM) is a behavioral treatment that provides monetary incentives contingent upon biochemical evidence of drug abstinence. This paper discusses the results of two studies that utilized CM to promote brief smoking cessation among opioid-maintained patients. Participants in a pilot study were randomly assigned for a 2-week period to a Contingent group that earned monetary vouchers for providing biochemical samples that met criteria for smoking abstinence, or a Noncontingent group that earned monetary vouchers independent of smoking status (Dunn et al., 2008). Results showed Contingent participants provided significantly more smoking-negative samples than Noncontingent participants (55% vs. 5%, respectively). A second randomized trial that utilized the same 2-week intervention and provided access to the smoking cessation pharmacotherapy bupropion replicated the results of the pilot study (55% and 17% abstinence in Contingent and Noncontingent groups, respectively; Dunn et al, 2010). Relapse to illicit drug use was also evaluated prospectively and no association between smoking abstinence and relapse to illicit drug use was observed (Dunn et al., 2009). It will be important for future studies to evaluate participant characteristics that might predict better treatment outcome, to assess the contribution that pharmacotherapies might have alone or in combination with a CM intervention on smoking cessation and to evaluate methods for maintaining the abstinence that is achieved during this brief intervention for longer periods of time.     

海洛因依赖者操守成败相关因素的调查分析

目的:探讨海洛因依赖者操守成败的相关因素及预防复吸的对策。方法:问卷调查35名戒毒后操守12个月以上及36名屡戒不成的海洛因依赖者,比较两组的人口学资料,操守成败相关因素。结果:成功操守者吸毒时间相对较短(P<0.01);戒毒次数和接受替代治疗相对较少(P<0.01);吸毒前对毒品认识不足(P<0.05)及因吸毒而受到的法律制裁较多(P<0.05)。维持操守的主要因素是正确的认知;而失败的因素是未脱离吸毒环境。结论:维持操守主要与正确的认知有关,据此制定综合性的预防复吸措施。     

人性照护行为的戒毒康复效果

目的:探讨人性照护行为对海洛因依赖者戒毒康复的应用效果,为进一步改进管教工作提供依据。方法:将120例海洛因依赖者随机分为研究组和对照组,各60例。研究组,制定管教关怀行为指南,实施为期8周的人性照护管教行为,对照组按常规管教,给予一般性(指导性)心理护理。用《关怀照护行为质量评价表》,自编《海洛因依赖者满意度/舒适度调查表》和《症状自评量表》(SCL-90)等评价工具进行评定。出院后,分别于2周、1个月和两个月进行随访和尿检,评价复吸情况。结果:干预后,各量表及复吸率评分两组比较,差异有显著性(P均<0.001)。结论:人性照护行为有利于戒毒管教工作的顺利开展和工作质量的提高,同时,对于海洛因依赖者的身心康复,降低复吸率,保持操守具有一定的积极作用。     

One-year follow-up after multimodal inpatient treatment for cocaine and methamphetamine dependecies

Of a randomly selected sample of 214 patients treated with aversion therapy for cocaine dependence in four chemical dependency units operated by Schick Shadel Hospitals, 156 were followed up 12 to 20 months posttreatment (average 15.2 months). Significant other validation was obtained in 33%. Total abstinence from cocaine for the group overall was 53% at one year post treatment, and current abstinence of at least 6 months at follow-up was 68.6%. Those treating with aversion for cocaine alone had a one-year abstinence of 39% and a current abstinence of 62.4%. Those treating with aversion for alcohol and cocaine had a one-year total abstinence from cocaine of 69% and a current abstinence of 76%. Those treating with aversion for cocaine and marijuana had a one-year total abstinence from cocaine of 50% and a current abstinence of 65%. Those treating with aversion for alcohol, cocaine, and marijuana had a one-year total abstinence from cocaine of 73% and a current abstinence of 73%. One-year total abstinence from alcohol was 54% for those receiving aversion for both alcohol and cocaine and 77% for those receiving aversion for alcohol, cocaine, and marijuana. Current abstinence from alcohol at follow-up was 68% and 81%, respectively. One-year total abstinence from marijuana was 42% for those treating with aversion for cocaine One-year total abstinence from marijuana was 42% for those treating with aversion for cocaine and marijuana and 64% for those treating with aversion for alcohol, cocaine, and marijuana. Current abstinence at follow-up from marijuana was 61% and 81%, respectively. The use of aversion therapy for both alcohol and cocaine in alcoholics who were also using cocaine was associated with higher total abstinence rates (88% vs. 55%) from cocaine when compared with alcoholics who used cocaine but received no aversion as part of their program. The conclusion is tentative since the follow-up rate in this study was lower than that of the previous study (64% vs. 84%). Being around other users accounted for 49% of relapse situations. Family/Work stress was associated with relapse in 33% of cases and unpleasant feelings in 24% of cases. The use of both reinforcement treatments and the use of support following treatment were associated with improved abstinence rates from cocaine. Those patients who reported losing all urges for cocaine after treatment had a total abstinence from cocaine of 90%, those who reported losing all the uncontrollable urges had a total abstinence of 64%, and those who reported still having the urge reported only 33% total abstinence from cocaine.