心理咨询干预对提高美沙酮维持治疗者合适剂量和治疗依从性效果的研究

目的 探讨心理咨询干预措施对提高参加美沙酮维持治疗(MMT)者的美沙酮治疗剂量以降低尿吗啡检测阳性率、减少毒品使用和增加治疗依从性的效果。方法 在16个社区MMT门诊招募近12周尿吗啡检测至少有1次阳性记录的治疗人员, 由医务人员进行每2周1次、同伴教育员每1周1次的心理咨询干预, 干预时间12周, 记录研究对象干预前和干预期12周内尿吗啡检测、日均服用美沙酮剂量和服药天数, 比较干预前和干预期间的变化。结果 共对492名研究对象实施了干预, 3项指标均有明显的变化: 尿吗啡检测阳性率从干预前的50.1%下降低到干预期间的27.1%, 平均日服用美沙酮剂量从干预前1周的63.0 mg增加到72.6 mg, 12周内服用美沙酮的天数从干预前的人均69.4 d增加到干预期间的人均73.9 d。 结论 强化咨询干预措施对于减少参加MMT海洛因成瘾者治疗期间偷吸毒品, 增加其服用美沙酮剂量, 提高治疗依从性有良好的效果。

Effects of psychological counseling intervention on increasing methadone dosage and reducing heroin use among patients receiving methadone maintenance treatment

Objective To learn about the effects of psychological counseling intervention on reducing heroin use, increasing methadone dosage and improving compliance rate of methadone maintenance treatment (MMT). Methods Subjects who had had at least one positive result for regular urine morphine tests during the past three months were recruited from 16 MMT clinics. During the three-month intervention period, the subjects received regular psychological counseling provided by doctors (once every other week) and peer education (once a week). Positive rates of urine morphine tests, average days receiving MMT during three months before the intervention and during the intervention, and average daily dosage of methadone during the last week before intervention and during the last week of the intervention programs conducted were recorded and compared. Results A total of 492 patients receiving MMT were surveyed. There were significant changes in positive rates for urine morphine tests, average daily dosage, and average days on MMT before and during the intervention programs. The positive rate for urine morphine tests dropped from 50.1% to 27.1%; the average daily dosage of methadone increased from 63.0 mg to 72.6 mg; the average days receiving MMT increased from 69.4 days to 73.9 days. Conclusion Intensive psychological counseling intervention was effective in reducing heroin use, increasing methadone dosage and improving compliance rate of MMT among patients receiving MMT.