美沙酮联用丁丙诺啡对海洛因依赖重度药瘾戒毒治疗临床研究

目的　探索对海洛因依赖重度药瘾较理想的戒毒治疗方法。　　方法　采用美沙酮与丁丙诺啡联合用药方案 ,对海洛因依赖重度药瘾 41例行戒毒治疗 ,1 2天为一疗程 ,并与单用美沙酮组 2 0例进行比较。　　结果　联合用药组控制症状较彻底 ,鸦片类药物戒断症状量表 (OWS)总分平稳下降 ,症状波动小 ,减药顺利 ,两药替换平稳 ,戒毒成功率 73 2 %。　　结论　我们认为美沙酮联用丁丙诺啡是一种值得推荐的戒毒治疗方法。     

美沙酮续用可乐定脱毒治疗

我们试用美沙酮短程替代后续用可乐定治疗海洛因依赖者，取得了满意的脱毒效果。现将治疗的８６例报告如下。１资料与方法１．１病例选择均为符合ＣＣＭＤ－２－Ｒ有关的诊断标准，有明确使用海洛因病史，尿检或发检阳性的强制戒毒病人。８６例中，男７４例，女１２例；年...     

美沙酮联合丁丙诺非治疗海洛因依赖者的疗效对比分析

在脱毒治疗中我们发现美沙酮控制戒断症状完全，但减药到低剂量时病人会出现明显的戒断反应，以至撤药困难，最终造成脱毒失败。为此，我们在其治疗的后期改用丁丙诺非与之联合则可减轻戒断症状。且撤药容易，病人依从性好。现将结果报告于后。     

516例海洛因依赖临床分析

５１６例海洛因依赖临床分析陈良艳魏晓云罗捷冉江峰对我院１９９５年３月～１９９６年６月自愿戒毒的海洛因依赖者５１６例进行分析：全部符合ＣＣＭＤ—２—Ｒ阿片类物质依赖诊断标准。男３４７例（７７．１％），女１１８例（２２．９％）。年龄男１５～４６岁，平均２...     

173例海洛因依赖的临床分析

吸毒在西方国家已成为严重的社会问题。美国海洛因泛滥最严重的时期是1960年代和1970年代,1969年左右达到高峰。我国近年来又重新出现贩毒吸毒现象,且有扩展蔓延趋势。本文就我院戒毒康复中心治疗的173例海洛因依赖者的临床资料,作如下分析。     

美沙酮合并泰尔登治疗海洛因依赖临床分析

有关在海洛因依赖者的临床脱毒过程中合理应用抗精神病药物的问题，一直是从事戒毒人员较为关心的问题之一。有关氯丙嗪、氯氮平和氟哌啶醇等抗精神病药物在脱毒治疗中的应用已有相应报道，而关于硫杂蒽类抗精神病药物的代表———泰尔登，在临床脱毒治疗中的应用报道甚少...     

海洛因依赖者自愿戒毒前后焦虑抑郁的评定

目的：探讨海洛因依赖者治疗前后焦虑抑郁症状。方法：对78例海洛因依赖者以抑郁自评问卷(BDI-l3)和汉密尔顿焦虑量表(HAMA)于治疗前后各评定1次。结果：治疗前有焦虑症状者52例，有抑郁症状者45例；治疗后分别为29和28例，均有明显减少。BDI-l3及HAMA评分亦明显下降。结论：经脱毒治疗，焦虑抑郁症状减少，有利于患者心理康复，但仍需加强心理护理。     

美沙桐与可乐定联合治疗海洛因依赖52例临床分析

在洛洛因依赖的急性脱瘾药物替代治疗中，目前主要使用美沙酮，但其递减法只能相对减少戒断症状的痛苦，却难以对付递减后期出现的迁延戒断症太，可乐定用于美沙桐替代治疗海洛因依赖中，后期，可使戒断症状明显减轻，患者能安全，平稳渡过戒断期，达到临床“显效。     

海洛因依赖的亚冬眠疗法与美沙酮疗法对照观察

对自愿戒断海洛因依赖住院患者１１６例，分别用亚冬眠与美沙酮替代递减进行治疗。结果表明：亚冬眠和美沙酮替代递减之间效果存在着明显差异；后者能有效控制戒断症状，且容易递减和停药，病人依从性好，不影响病人意识，生活能自理，情绪平稳，副反应极少。     

立体定向毁损术治疗海洛因心理依赖(18个月随访分析)

目的探讨立体定向毁损治疗海洛因心理依赖手术疗效及安全性。方法应用立体定向手术治疗海洛因心理依赖58例,并于术后3个月、18个月进行随访,采用上门家访或电话随访。随访内容包括复吸与否、生活工作情况、有无神经精神功能障碍。上门家访时进行了渴求量表、欲望量表、记忆、智商、人格等精神心理测验。结果未复吸36例,复吸16例,失访6例,操守率为62.06%。记忆、智商、性欲比术前提高,无人格、行为等精神障碍。结论立体定向手术治疗海洛因心理依赖疗效明显优于常规药物戒毒治疗,是消除吸毒者心理依赖、摆脱毒瘾的有效方法,且对智力、欲望、思维、人格无明显负面影响。     

美沙酮维持治疗海洛因依赖患者的吸烟行为与疼痛强度

目的探讨接受美沙酮维持治疗(methadone maintenance treatment,MMT)的海洛因依赖患者(heroindependent patients,HDPs)吸烟行为与疼痛强度关系。方法 603例MMT门诊HDPs完成社会人口学和临床特征问卷、吸烟问卷、吸烟严重程度指数评估和Zung氏抑郁自评量表,用五点口述分级评分法评估疼痛强度。结果协方差分析控制社会人口学变量、临床特征变量和抑郁症状的混杂作用后,吸烟HDPs的疼痛强度高于非吸烟HDPs(F=11.836,P=0.002),两两比较,中重度尼古丁依赖患者疼痛强度最高,轻度尼古丁依赖患者次之,无尼古丁依赖患者疼痛强度最低[(3.11±1.04)vs.(2.67±1.13)vs.(2.47±1.15),均P0.01]。结论 MMT门诊HDPs的吸烟行为与疼痛存在显著关联,尼古丁依赖程度越重,疼痛强度越高。     

海洛因依赖者认知功能障碍的WCST对照研究

目的 采用威斯康星卡片分类测验(Wisconsin Card Sorting Test, WCST)分析海洛因依赖者认知功能损害情况.方法 分别对60例住院脱毒治疗的海洛因依赖者与40例正常对照者进行WCST测验.结果 与正常对照相比,海洛因依赖组WCST的总应答数(100.6±20.2)、完成分类数(5.4±1.4)、概念化水平百分数(87.9±13.0)%等测验值均较正常组差(海洛因依赖组60例,正常对照组40例,P<0.05);男女海洛因依赖者WCST测验结果无显著差异;相关性分析发现海洛因依赖者年龄、受教育年限、用毒品年限、每日使用量与WCST测验结果之间没有显著相关性.结论 海洛因依赖者存在认知功能损害,应对海洛因依赖者进行系统的康复治疗改善其认知功能预防复发.     

海洛因依赖复吸者心理缺陷感及外控性的临床调查分析

目的：了解海洛因依赖复吸者的心理缺陷感及外控性。方法：采用缺陷感量表（ＦＩＳ）与在人Ｎｏｗｉｃｋｉ＝Ｓｔｒｉｃｋｌａｄｎ内－外控制量表（ＡＮＳＩＥ）对６０例海洛因依赖复吸者及６０例健康成人进行测评。结果：海洛因依赖复吸者心理缺陷感评分明显低于健康成人,在自尊、社交、学习能力、外貌、体能及总分呈显著性差异;同时外控性评分显著高于健康成人。结论：海洛因依赖复吸者的强烈的心理缺陷感及外控必不利于利其渡过     

The economic cost of heroin dependency and quality of life among heroin users in Taiwan

Heroin dependence may cause an economic burden and has an impact on quality of life (QOL). However, assessments of economic cost are scarce and the relationship between economic cost and QOL is unclear in the Asian population. In the present study, an established questionnaire was modified to assess the economic cost and its association with QOL. A total of 121 volunteer subjects in a methadone maintenance therapy programme and 157 normal controls were enrolled. The total economic cost of heroin dependency is US$ 18,310 per person-year. The direct cost is US$ 11,791 per person-year (64% of the total cost), mostly consisting of the cost of heroin and other illegal drugs. The indirect cost is US$ 6519 (36% of the total cost) per person-year, most of which arises from productivity loss caused by unemployment and incarceration. The QOL of heroin-dependent patients is poorer than that of healthy controls in all domains. The overall QOL is negatively related to direct cost and total cost. The economic cost of heroin dependency is huge, equal to 1.07 times the average gross domestic product per capita. Reduction of the economic cost to society and the economic burden for heroin users is important.     

广州地区海洛因依赖104例临床分析

本文分析104例首次住入我院二科的海洛因依赖者的临床资料。男性97人,女性7人,平均年龄27.6±4.5岁,84.6％为个体户,89.4％的吸毒史在3年内。吸毒后期将海洛因放在香烟内吸或烫吸68人,静脉或肌肉注射36人。使用不同的药物治疗均可达到消除戒断症状目的。平均住院7.7±3.3天。出院后短期复吸海洛因者相当多,长期的康复治疗和善后照顾对防止复吸很有必要,加强康复机构的建设是当务之急。     

开放疗程时丁丙诺啡治疗海洛因依赖的疗效

总结开放疗程时肌注丁丙诺啡治疗８９例海洛因依赖者的临床疗效，总有效率为８３％，治疗时间９～２５天不等，治疗后能撤除丁丙诺啡的占６４％，其中１／３以上的治疗时间超过１０天。结果表明，丁丙诺啡的有效治疗时间因人而异，对疗程不宜作统一规定，该药对某些戒断反应严重者效果不佳。     

帕罗西汀治疗海洛因领带者焦虑抑郁的研究

目的:了解帕罗西汀治疗海洛因依赖者焦虑抑郁的疗效与不良反应.方法:对海洛因依赖者伴发焦虑和抑郁的患者.在治疗前,治疗后,1,2,4和6周末分别以Hamilton焦虑量表(HAMA),Hamilton抑郁量表(HAMD),不良反应症状量表(TESS)及临床总体印 量表(CGI)评定.结果:帕罗西汀对海洛因依赖者伴发的焦虑抑郁症状有良好疗效,不良反应以口干,便秘,恶心,头昏等多见.结论:帕罗西汀能有效地缓解海洛因依赖者焦虑抑郁情绪.     

A prospective observational study of heroin users in Johannesburg,South Africa: Assessing psychiatric comorbidities and treatment outcomes

BackgroundDespite the rise in heroin use in sub Saharan-Africa opioid agonist maintenance treatment (OAMT) is still not state-funded in South Africa and many other African countries. In South Africa there has been little data published on the profile of heroin users and the outcomes of treatment for those who attend public treatment services.Methods300 heroin users from two state-funded rehabilitation centres in Johannesburg were studied at entry into rehabilitation and 3-months after treatment. Treatment consisted of inpatient detoxification and inpatient psychosocial rehabilitation. Structured interviews measured changes in drug use, psychopathology and criminality post rehabilitation.ResultsMost (65.7%) smoked heroin in combination with cannabis while 29.7% were injecting users. Almost half the sample (49.3%) had at least one mental illness. Of the 252 (84%) participants seen at 3-month follow-up, 6.3% were abstinent of all substances (excluding tobacco), 65.5% had continued heroin use (CHU) and the balance used other substances. At follow-up there were significant decreases in heroin use (p < 0.0001) and criminality (p < 0.0001). There were however significant increases in alcohol use (p < 0.0001), crystalmetamphetamine use (p = 0.032) and the prevalence of current episode of major depression (p < 0.0001). Just 11.9% received formal psychosocial treatment after leaving rehabilitation. None were on OAMT and only three participants were on psychotropic medication. None were tested for Hepatitis C during the study period and the majority (53%) did not know their HIV status.ConclusionThere are significant gaps in current treatment services for heroin users in South Africa. Retention in treatment and assessment and management of psychiatric and non-psychiatric comorbidities is low. Services need to be more integrated and should also include the provision of OAMT.