手术戒毒成功率高--浅谈外科手术戒毒

吸毒是一个世界性问题，除大力宣传毒品危害，严厉打击制毒、贩毒犯罪活动外，更重要的是应该开展科学研究，探索戒毒者复吸原因．这是当务之急。中国人民解放军广州空军医院神经外科较早开始进行戒毒手术，现已成功为7位吸毒患者戒毒。     

戒毒者自杀意念与领悟社会支持和家庭功能的相关性分析

目的了解戒毒者自杀意念现状,探讨家庭功能和社会支持与戒毒者自杀意念发生的关系。方法应用一般情况调查表、自编自杀情况调查表、领悟社会支持量表和家庭功能评估问卷表对488名戒毒所服刑的戒毒者进行调查。结果 488名戒毒者戒毒前自杀意念发生率为16.39%,戒毒后自杀意念发生率为24.59%,戒毒后自杀意念发生率高于戒毒前(P0.01);有自杀意念的戒毒者领悟社会支持总分、朋友支持得分、其他支持得分和家庭功能总分均低于无自杀意念戒毒者(P0.05或0.01);朋友支持(OR=0.52,95%CI=0.34～0.80)(P0.01)和首次吸毒年龄(OR=0.76,95%CI=0.59～0.97)与戒毒后戒毒者自杀意念发生呈负相关。结论提高朋友支持以及保护低龄者免受毒品侵害,有利于改善戒毒者戒毒后自杀意念状态。     

O‘Brien的非参数与参数综合法及其在生命质量资料分析中的应用

介绍并讨论Ｏ‘Ｂｒｉｅｎ的非参数与参数方法在生命质量资料分析中的应用，并对两戒毒组吸毒者的生命质量进行比较。方法：随机抽取１５８例强制戒毒者的５４例自愿戒毒者，用我们研制的吸毒者测定量表ＱＯＬ－ＤＡ对其进行测定，用’ＯＢｒｉｅｎ的非参数及参数方法进行分析。     

发挥"角色模范"作用带动目标人群的转变--对昆明市IDU的行为干预

针对昆明市吸毒者多，由吸毒特别是共用注射器和高危性行为引起的艾滋病的传播和扩散现象严重，项目以同伴教育为切入点，以减低HIV的传播和扩散为目的，在IDU（注射吸毒人群）中开展了针具交换、社区外展、同伴教育、安全套推广、吸毒者和戒毒者自助互助小组、吸毒者和戒毒者家庭联谊活动、转介服务等综合干预活动，促进了IDU性病艾滋病相关知识的增长，降低了其相关危险行为。     

男性戒毒者焦虑抑郁状况及其影响因素分析

目的 了解男性戒毒者焦虑和抑郁水平及其影响因素.方法 整群抽取广东省韶关市强制隔离戒毒所和韶关市公安强制隔离戒毒所戒毒人员共600人,采用综合性医院焦虑抑郁量表、简易应对方式量表和领悟社会支持量表进行问卷调查.结果 获得有效问卷544份,544名男性戒毒者中,存在焦虑症状的338人,占62.1％,存在抑郁症状的327人,占60.1％,同时存在焦虑、抑郁症状的246人,占45.2％;戒毒者领悟社会支持为(55.04±13.16)分,积极应对为(22.08±5.06)分,消极应对为(13.01±4.19)分;焦虑症状受学历的影响,抑郁症状受年龄、学历、戒毒时间和戒毒次数的影响(均P ＜0.05);抑郁得分与社会支持总分及积极应对方式呈负相关(r=-0.300、-0.373,P＜0.05);应对方式是男性戒毒者焦虑抑郁水平的预测因素,积极应对方式比消极应对方式影响力大.结论 男性戒毒者焦虑抑郁症状的发生率较高,其焦虑抑郁水平受个人应对方式的影响.     

142名男性戒毒者社会支持与生活质量调查分析

[目的]探讨男性戒毒者社会支持、生活质量现状及两者间关系.[方法]运用世界卫生组织生存质量量表简表和社会支持评定量表对142名男性戒毒劳教者进行调查分析.[结果]男性戒毒者社会支持分值偏低;其生活质量量表得分各领域均显著低于常模;控制了人口学变量后,分层回归分析显示主观支持能预测生活质量的生理领域和社会领域;主观支持和对支持的利用度能共同预测生活质量的心理领域,其中支持利用度贡献更大.[结论]提高戒毒者的社会支持水平是改善其生活质量的有效方法.     

湛江市强制戒毒者生存质量和社会支持现状分析

目的了解湛江市强制戒毒者生存质量和领悟社会支持现状及其相关性,为提高戒毒者生存质量和毒瘾矫治教育提供科学依据。方法采用包括基本情况、领悟社会支持量表和世界卫生组织生存质量量表简表的自制调查问卷对湛江市戒毒所的强制戒毒者进行调查,数据采用t检验、方差分析和Pearson相关分析等统计学方法进行分析。结果共调查488名男性强制戒毒者,平均年龄(39.32±7.90)岁,入所时间以6～12个月为主,占47.75%(233/488)。强制戒毒者领悟社会支持总分(52.12±13.52)分、家庭支持得分(18.02±5.45)分和其他支持得分(17.01±4.91)分,均高于国内常模(均P0.01),朋友支持得分(17.09±5.07)、生理领域(54.53±15.09)、心理领域(53.20±16.13)、社会关系领域(55.67±18.94)和环境领域(49.14±17.07)得分均低于国内常模(均P0.01)。调查对象年龄越低其心理领域和环境领域得分越高,文化程度越高其生理领域、心理领域、环境领域、领悟社会支持、家庭支持、朋友支持和其他支持得分越高,已婚的调查对象社会关系领域和家庭支持得分高于不稳定婚姻状态,有职业的调查对象社会关系领域和环境领域得分高于无职业者,收入越高其生理领域、心理领域、社会关系领域、环境领域、领悟社会支持和家庭支持得分越高,入所时间越长其心理领域、环境领域和其他支持得分越高,差异均有统计学意义(均P0.05)。结论湛江市强制戒毒者生存质量和领悟社会支持水平较低,应提高政府、社会、家庭对戒毒者的社会支持。     

如何对自愿戒毒者强化管理

如何对自愿戒毒者强化管理严崇荣李秀芝作者单位：６１８０１３四川省德阳市戒毒中心目前，我国吸毒者达５２万，禁毒、戒毒工作引起了党中央、国务院和全社会的高度重视。１９９５年经四川省卫生厅、公安厅批准，德阳市戒毒中心收治近百名自愿戒毒患者并进行分析，大多文...     

北京市某强制戒毒治疗管理处吸毒人员生命质量分析

目的了解戒毒人员、生命质量状况,为采取相关措施提供理论依据。方法采用药物成瘾者生命质量测定量表(QOL-DA)对153名吸毒人员进行调查,测定不同吸毒者生命质量。结果此次调查的戒毒人员以30～40岁、男性、汉族、初中文化程度、离异、无业人员为主,吸毒者毒龄以6～60个月为主,占66.7%;吸食毒品种类66%为海洛因,60.1%吸食方式为烫吸,静脉注射占39.9%;55.6%的人已多次戒毒。克伦巴赫系数大于0.7,生命质量量表在本次调查中信度较高。烫吸组心理功能(21.74±6.90)、社会功能(31.01±6.01)以及QOL-DA总分(96.17±18.81)高于静脉注射组,差异有统计学意义(P<0.05);首次戒毒者心理功能(22.91±7.19)、戒断症状(22.07±7.29),以及QOL-DA总分(99.85±19.29)高于多次戒毒者,差异有统计学意义(P<0.05)。文化程度越高,心理功能得分越高(P<0.05)。结论对静脉注射吸毒者以及多次戒毒者在强制戒毒治疗时应加强心理疏导、行为矫正。     

O′Brien的非参数与参数综合法及其在生命质量资料分析中的应用

介绍并讨论Ｏ′Ｂｒｉｅｎ的非参数与参数方法在生命质量资料分析中的应用，并对两戒毒组吸毒者的生命质量进行比较。方法：随机抽取１５８例强制戒毒者的５４例自愿戒毒者，用我们研制的吸毒者测定量表ＱＯＬ－ＤＡ对其进行测定，用Ｏ′Ｂｒｉｅｎ的非参数及参数方法进行分析。结果：两戒毒组生命质量比较的Ｏ′Ｂｒｉｅｎ非参数检验ｔ＝－０．９５，Ｐ＝０．３４，两组的平均秩和分别为：４１８．０６，４４９．２２；参数检验Ｆ＝０．５２，Ｐ＝０．４７。结论：Ｏ′Ｂｒｉｅｎ的非参数与参数法是一种较好的生命质量资料分析方法，值得推广应用。经Ｏ′Ｂｒｉｅｎ法分析，两戒毒组的生命质量无统计学差异。     

HIV risk-related behaviors among injection drug users in Rome: differences between 1990 and 1992.

Temporal differences in human immunodeficiency virus (HIV) risk-related behaviors among injection drug users in Rome, Italy, were analyzed in 487 drug users recruited in 1990 and 450 recruited in 1992. Sharing of syringes decreased among self-reported HIV-positive drug users between 1990 and 1992, but there was no change in their sexual behavior. Fewer HIV-seronegative drug users reported passing on used syringes in 1992 than in 1990; however, there was no change in the percentage of seronegative subjects using previously used syringes, and a reduction in condom use with primary partners. There still exists a great potential for transmission of HIV infection among injection drug users and from injection drug users to the general population.     

HIV seroprevalence among street-recruited injection drug and crack cocaine users in 16 US municipalities.

OBJECTIVES: This study deter- mined human immunodeficiency virus (HIV) seroprevalence and factors associated with HIV infection among street-recruited injection drug users and crack cocaine smokers. METHODS: An analysis was performed on HIV serologies and risk behaviors of 6402 injection drug users and 3383 crack smokers in 16 US municipalities in 1992 and 1993. RESULTS: HIV seroprevalence was 12.7% among injection drug users and 7.5% among crack smokers. Most high-seroprevalence municipalities (>25%) were located along the eastern seaboard of the United States. In high-seroprevalence municipalities, but not in others, HIV seroprevalence was higher for injection drug users than for crack smokers. Among injection drug users, cocaine injection, use of speedballs (cocaine or amphetamines with heroin), and sexual risk behaviors were independently associated with HIV infection. Among crack smokers, sexual risk behaviors were associated with HIV infection. CONCLUSIONS: Injection drug users and crack smokers are at high risk for HIV infection.     

吸毒人群丙肝感染现状研究

目的：了解吸毒人群丙肝（HCV）感染现状，为控制丙肝的传播提供科学依据。方法：采用血清流行病学方法，应用酶联免疫吸附法（ELISA）检测250例吸毒人群血清丙肝病毒抗体（抗-HCV）。结果：吸毒组血清丙肝抗体阳性201例，感染率为80．4％；对照组100例血清丙肝体阳性2例，感染率为2％，吸毒人群丙肝感染率是普通人群的40．2倍。结论：吸毒人群是丙型肝炎的重要传染源，有关部门应加强吸毒人员管理，防止丙肝在人群之间的传播。     

Expanding the frame of health services research in the drug abuse field.

OBJECTIVE. This article examines the distribution of heavy drug users across health and social service agencies in a community, and ways in which organizational and social policy factors influence pathways to services. DATA SOURCES/STUDY SETTING. Data are from the Community Epidemiology Laboratory, a project that includes comparable surveys of a wide variety of client, service provider, and general population groups in a single northern California county. STUDY DESIGN. The design is a cross-sectional analysis of patterns of service use and referral by heavy drug users distributed across a variety of service settings and in the general population. DATA COLLECTION. In-person, structured interviews by trained interviewers were conducted using comparable instruments, measures, sampling strategies, and fieldwork procedures. PRINCIPAL FINDINGS. The specialty drug treatment system serves only a small proportion of heavy drug users in the community. Large proportions of drug users are found in criminal justice, primary health, and welfare agencies. Patterns of service encounter and referral suggest that drug treatment clients typically have been in jail or on welfare prior to attending treatment, and are far less likely to have been referred to or from treatment by health providers. CONCLUSIONS. Health services research on drug abuse should expand its frame of reference to include services outside the specialty treatment sector. Drug treatment facilities are somewhat remote from other agencies in community service networks and are organizationally dependent on criminal justice and welfare systems. Further research should investigate both the costs and benefits of screening and providing services at earlier points of institutional involvement with drug abusers and the implications of interorganizational dependencies among criminal justice, welfare, and drug agencies for providers and clients.     

The consistency of self-reported HIV risk behavior among injection drug users.

OBJECTIVES. Most studies of risk factors for human immunodeficiency virus (HIV) rely heavily on retrospective self-reports. The degree to which these reports provide reliable information has received little research attention. The purpose of this study was to assess the extent to which the reliability of retrospective self-report data is affected over time. METHODS. Data were examined from a longitudinal study of risk behaviors among injection drug users. Structured interviews were administered to 366 injection drug users who were asked to recall behaviors that they had reported 6, 12, or 18 months earlier. RESULTS. Kappa coefficients showed moderate initial memory loss for injection and sexual risk behaviors. After 6 months, time had little effect on the ability of injection drug users to recall injection and sexual risk behaviors. For ordinal measures of risk, subjects who gave different reports over time were most likely to disagree by one response category. CONCLUSIONS. These findings support the use of retrospective self-reports in assessing HIV risk behaviors among injection drug users. Retrospective inquiry is likely to remain an important method for collecting data over time.     

Estimating the number of HIV-infected injection drug users in Bangkok: a capture--recapture method.

OBJECTIVES. The purpose of the study was to estimate the number of injection drug users infected with the human immunodeficiency virus (HIV) in Bangkok to allow planning for health services for this population. METHODS. A two-sample capture-recapture method was used. The first capture listed all persons on methadone treatment for opiate addiction from April 17 through May 17, 1991, at 18 facilities in Bangkok. The second capture involved urine testing of persons held at 72 Bangkok police stations from June 3 through September 30, 1991. Persons whose urine tests were positive for opiate metabolites or methadone were included on the second list. RESULTS. The first capture comprised 4064 persons and the recapture 1540 persons. There were 171 persons included on both lists, yielding an estimate of 36,600 opiate users in Bangkok. Existing data indicate that 89% of opiate users in Bangkok inject drugs and that about one third are infected with HIV, yielding an estimate of approximately 12,000 HIV-infected injection drug users in Bangkok in 1991. CONCLUSIONS. During the 1990s the number of cases of acquired immunodeficiency syndrome (AIDS) and other HIV-related diseases, including tuberculosis, in the population of HIV-infected injection drug users in Bangkok will increase dramatically, placing new demands on existing health care facilities. The capture-recapture method may be useful in estimating difficult-to-count populations, including injection drug users.     

武汉市吸毒人群艾滋病行为监测结果分析

目的评估武汉市吸毒人群艾滋病感染危险因素,为艾滋病疫情趋势预测和干预提供依据。方法采用机械抽样的方法对吸毒者进行面对面问卷调查。结果调查对象对艾滋病缺乏全面了解,44.25%的吸毒者曾经共用过注射器,8.41%的吸毒者最后一次吸毒共用注射器,21.18%的吸毒者有临时性伴,平均临时性伴数为4人,临时性伴最后一次安全套使用率为18.52%,14.51%的吸毒者有商业性伴。结论武汉市吸毒人群共用注射器比例较高,安全套使用率较低,需要对吸毒人群进行长期连续性的行为监测。     

Needle sharing and participation in the Amsterdam Syringe Exchange program among HIV-seronegative injecting drug users.

To enhance the prevention of human immunodeficiency virus infection, factors related to regular participation in the Amsterdam Syringe Exchange and the borrowing of syringes were studied in 131 HIV-seronegative injecting drug users in a 1989-90 survey. A total of 29 percent of the users reported borrowing syringes, that is injecting drugs at least once in the past 4-6 months with a needle or syringe previously used by someone else. Users at increased risk of borrowing are previous borrowers, long term moderate-to-heavy alcohol users, current cocaine injectors, and drug users without permanent housing. Regular clients of the syringe exchange, when compared with other injecting drug users, were found more often to be frequent, long term injectors. They borrowed slightly less often than other users, but this was not statistically significant, even after controlling for frequency of injecting or other potential confounders. The results suggest that, 5 years after the start of the Amsterdam Syringe Exchange, drug use characteristics govern an individual injecting drug user's choice of exchanging or not exchanging syringes. The conclusion is that it seems more important to direct additional preventive measures at injecting drug users with an increased risk of borrowing rather than at users who do not participate in the syringe exchange or who do so irregularly.     

吸毒者艾滋病感染和传播相关行为的研究

目的　了解吸毒者与艾滋病感染和传播有关的行为 ,以指导对吸毒者开展的艾滋病综合干预。方法　用滚雪球法在绵阳市和西昌市的社区中寻找吸毒者 ,用社会学的个人深入访谈和流行病学问卷进行调查。结果　共调查 36 3名吸毒者 ,其中采用过静脉注射者占 96 4 1% (35 0 / 36 3) ;绵阳、西昌 2地吸毒者年龄、婚姻分布相近 ,文化、职业、经济收入等有明显差异 ;绵阳市吸毒者共用注射器者占 34 1% ,西昌市为 5 8 8% ;注射器不消毒、或用清水和开水清洗较多 ;在与其他性伴发生性行为时 ,绵阳市、西昌市仅有 33 3%和 30 8%的吸毒者使用安全套。结论　 2地的吸毒者共用针率较高、针具清洁方法不正确 ;非婚性安全套使用率低 ,存在较大的感染和传播艾滋病危险 ,特别是收入和文化程度较低的吸毒者更危险 ,应尽快针对吸毒人群开展针具交换、美沙酮维持、安全套使用促进、完善性病和HIV自愿咨询检测服务。     

Sexual risk behavior of incarcerated,drug-using women, 1992.

In this study, sexual risk behavior of 104 incarcerated female drug users is examined. Findings demonstrate that incarcerated women who use drugs are at high risk for human immunodeficiency virus (HIV) infection because of their behavior prior to arrest. During the month prior to arrest, the majority of respondents were sexually active. Half reported past sexual contacts with injecting drug users, and more than one-third had traded sex for money or drugs. Consistent with other studies, condom use was more frequent with casual or commercial partners. Those who traded sex for money were less likely to be white Anglo or regular heroin users, and more likely to be regular crack users and alcoholic, have fathers who were drug or alcohol users, and perceive themselves as at-risk for contracting HIV and other sexually transmitted diseases.