围绕美沙酮治疗开展社区戒毒

吸毒成瘾是慢性复发性大脑疾病,吸毒成瘾后强迫性觅药随着时间延长、用药量逐渐加大和用药间隔时间缩短,对身体损害也日渐加重,失去了原来的自我,并伴有明显的行为、心理、个人功能、家庭功能及社会功能的损害。严重的违法犯罪,寿命缩短,感染、传播艾滋病、乙肝、丙肝等多种严重疾病,吸毒的人数在不断上升,浪费了社会大量的人力、物力、财力,对社会公共安全危害也在疾速增加,对社会发展有着严重影响,     

戒毒所内对吸毒人群进行艾滋病干预的效果研究

目的：评价在戒毒所进行艾滋病咨询及心理干预对吸毒人群戒毒的效果。方法采用自行设计的问卷,以面对面询问方式,对戒毒所内的吸毒人员进行干预前后调查。结果261名吸毒者接受了干预前问卷调查,其中132例自愿参与咨询、接受心理干预,并做了干预后调查。干预后吸毒人群对艾滋病防治、性传播疾病、自愿咨询检测知识知晓率均明显提高;自愿咨询检测利用率、性病就诊行为好转率均有明显提高。结论在戒毒所开展咨询与心理干预,可以提高吸毒人群艾滋病的防治知识,改变相关危险行为,在戒毒所对吸毒人群开展艾滋病咨询与心理干预是预防艾滋病在吸毒人群中传播的有效途径。     

男性吸毒劳教者与普通劳教者生存质量对比研究

目的：探讨男性吸毒劳教人员与普通劳教人员的生存状况差异及其影响因素。方法：运用世界卫生组织生存质量量表简表,对340名男性吸毒劳教人员和普通劳教人员进行问卷调查。结果：普通劳教人员在生存质量量表的生理、心理和社会三领域得分显著低于常模,而吸毒劳教人员的各领域得分均显著低于普通劳教人员;文化程度和婚姻状况对普通劳教人员无明显影响,而在吸毒劳教人员则差异显著;两者的生存质量均随年龄增长而降低。结论：劳教模式和吸毒、戒毒行为作为同时存在的两个重要影响因素,共同影响了吸毒劳教者的生活质量。     

中国青少年吸毒现状、影响因素及干预对策

近年来，随着国家经济水平的提高，禁毒工作显著，吸毒问题日益好转，但随着禁毒工作的开展发现，吸毒人员低龄化显著，青少年吸毒问题依旧层出不穷，本文通过梳理归纳后发现，青少年吸毒呈现低龄化趋势，其中女性初吸年龄明显低于男性，且女性吸毒者的比例也在逐渐上升。青少年的吸毒与复吸也和所处社会网络有一定的关联。青少年吸毒的影响因素众多，其中受好奇心趋势、家庭环境的影响、学校的教育方式及所处的社会网络影响较为明显。最后，通过观察影响因素和社会网络的吸毒前后变化，从正确引导认知，改变教育方法，建立良好的青少年网络关系和加强青少年心理关怀四个方面，给出一定的干预建议及对策，以期为毒品戒治工作提供参考。     

吸毒行为的社会、地理因素分析

本文对４６８例海洛因依赖者进行了社会和心理调查。结果显示：年龄轻、文化程度低、职业不固定、性心理素质差、婚姻不幸福和家庭结构不健全与吸毒行为发生有密切关系；自控能力差、情绪不稳定、适应不良、意志薄弱以及责任感缺乏是吸毒者人格特征的突出表现；矛盾心理、隐私心理、自私心理、脆弱与孤独、逆反心理为吸毒者的主要心理特征。健全法制加强禁毒的宣传教育，断绝毒品来源，控制不良的社会和心理因素产生，加强青少年性科学教育，提高社会人群性知识水平和性道德观念而提高性心理素质，是预防吸毒的有效方法，对吸毒者进行药物和心理治疗，积极开展性心理还原过程，发挥社会支持系统的作用，建立严密监护网络是戒断吸毒行为提高、巩固康复率的必要措施。     

强制隔离戒毒人员团体心理辅导效果初探

目的:探讨团体心理干预对强制隔离戒毒人员心理功能恢复所起的作用和效果,为强制隔离戒毒所有效地开展心理矫治工作提供科学依据。方法:试验组45例强戒人员进行团体心理干预,包括:集体讲座、情境模拟、投射练习等各种团体活动。对照组同期45例强戒人员不进行相应的心理干预。使用卡特尔16种个性因素测验及90项症状自评量表在干预前后进行评定,用SPSS社会统计软件进行统计分析,评价干预效果。结果:经过10周的心理干预,研究组的情绪稳定性、紧张性、适应与焦虑、心理健康因素、强迫、抑郁、敌对、人际关系等各项症状有了明显改善(P<0.01),对照组没有明显变化(P>0.05)。结论:吸毒人员进入强制隔离戒毒所后,经过环境适应、情绪的调节与控制、自我意识、自信心、人际关系等5个单元的团体心理干预,其消极自我认知、偏执、抑郁、焦虑、人际关系敏感、情绪稳定性等各项心理症状及功能有了明显的改善和缓解,这对他们戒除"心"瘾起到了一定的促进作用。     

1982—1995年云南省陇川县吸毒情况变化

对云南省陇川县１９８２年以来的吸毒情况进行了分析，我们发现８２至８５年吸食雅片的人数逐年增加。可是从８６年出现吸食或注射海洛因以后，吸食或注射海洛因的人数逐年增加，而吸食雅片烟的人数却逐年减少。男性鸦片和海洛因的吸毒率均显著高于女性（Ｐ〈０．００１），傣族和景颇族男性和女性的雅片与海洛因吸毒率均显著高于汉族（Ｐ〈０．００１），男性和女性的鸦片吸毒率与文化程度呈反方向剂量反应关系（Ｐ〈０．００１）。     

心理行为干预对美沙酮维持治疗病人生活质量的影响

目的:了解心理行为干预对美沙酮维持治疗病人生活质量的影响。方法:使用简单随机分组方法将200例美沙酮维持治疗病人分为干预组和对照组,各100例。干预组进行心理与行为干预,对照组不做任何干预。采用肖琳等编制的《吸毒人员生活质量量表》,对两组被试干预前后的生活质量数据进行独立样本t检验。结果:干预组前后测比较及与对照组后测比较,除毒品依赖维度外,总分及其他各维度均达到显著差异水平(P<0.001或<0.05);干预组的生活质量有了显著提高(P<0.001)。结论:心理与行为干预对美沙酮维持治疗病人心理和社会功能的康复、生活质量的改善与提高有显著效果。     

抗逆力视角下青少年吸毒行为分析及社会工作介入

本文认为,青少年吸毒行为的形成是个体抗逆力激发失败而导致的个体环境适应不良的结果。青少年成长过程中内在与外在保护性因素的缺失及风险性因素的增加是导致青少年吸毒行为的重要原因。针对青少年环境适应不良而引起的行为越轨的现状,社会工作者应引导吸毒青少年建构积极意义、重构生活,用"常规途径"代替"非常规途径",挖掘其背后的抗逆力,促进其正向成长与发展。     

北京市吸毒人群安全性行为知信行调查

目的：了解北京市吸毒人员有关安全性行为的知识、态度及行为情况，为预防控制艾滋病、性病在该人群的流行提供科学依据。方法：对北京市某自愿戒毒所277名吸毒者进行安全性行为的知识、态度及行为问卷调查，并对结果进行统计和分析。结果：吸毒人员关于性交时正确使用安全套能预防艾滋病的知晓率最高（93.9％），认为与临时性伴性交安全套应使用率显著高于与熟人的应使用率，与固定性伴性交安全套每次使用率最低。结论：吸毒人群中存在多性伴、不安全性行为等高危因素，在吸毒人群中开展安全性行为的宣传教育并深入推广安全套的使用，对控制艾滋病、性病的传播具有重要意义。     

Factors influencing PRN medication use in nursing homes

OBJECTIVE: To identify determinants of PRN (as needed) drug use in nursing homes. Decisions about the use of these medications are made expressly by nursing home staff when general medical practitioners (GPs) prescribe medications for PRN use. METHOD: Cross-sectional drug use data were collected during a 7-day window from 13 Australian nursing homes. Information was collected on the size, staffing-mix, number of visiting GPs, number of medication rounds, and mortality rates in each nursing home. Resident specific measures collected included age, gender, length of stay, recent hospitalisation and care needs. MAIN OUTCOME MEASURES: The number of PRN orders prescribed per resident and the number of PRN doses given per week averaged over the number of PRN medications given at all in the seven-day period. RESULTS: Approximately 35% of medications were prescribed for PRN use. Higher PRN use was found for residents with the lower care needs, recent hospitalisation and more frequent doses of regularly scheduled medications. With increasing length of stay, PRN medication orders initially increased then declined but the number of doses given declined from admission. While some resident-specific characteristics did influence PRN drug use, the key determinant for PRN medication orders was the specific nursing home in which a resident lived. Resident age and gender were not determinants of PRN drug use. CONCLUSION: The determinants of PRN drug use suggest that interventions to optimize PRN medications should target the care of individual residents, prescribing and the nursing home processes and policies that govern PRN drug use.     

Patterns of ketamine use among young injection drug users

Ketamine is a dissociative anesthetic that has emerged as an increasingly popular choice among young drug users. Recent research indicates the presence of hidden populations of young people who inject ketamine in New York and other U.S. cities. Applying an ethno-epidemiological approach, the authors recruited 40 young injection drug users (IDUs) (< 25 years old) in New York City to explore health risks associated with ketamine use. This analysis looks at the varying patterns and frequencies of ketamine injection by examining personal, social, and cultural aspects of these young people's lives. We learned that drug-using histories, experiential dimensions, sociocultural characteristics, and associations with other young people help account for the different patterns of injecting ketamine within the sample. In particular, these findings indicate that young people who were more frequent ketamine injectors had the following characteristics: initiated injection drug use with ketamine; enjoyed the effects of ketamine, were stably housed; lived in the vicinity of New York City; and associated with others who also injected ketamine.     

Buprenorphine for opioid dependence

In England and Wales, estimates suggest around 250,000 people have serious drug problems such as dependency, that cause considerable harm to themselves and others, and give rise to high social and economic costs. The number of people receiving specialist treatment for drug problems has increased greatly in recent years. Many people dependent on opioids will require opioid substitution treatment at some time. This may involve long-term maintenance to reduce use of illicit drugs, and/or short-term detoxification to stop such use completely. Standard management involves methadone maintenance therapy. Buprenorphine (Subutex-Schering-Plough) is also licensed for the management of patients with opioid dependence. Here we review the evidence for the use of buprenorphine compared with methadone for opioid dependence.     

Increasing exposure to drug-drug interactions between 1992 and 2005 in people aged > or = 55 years

BACKGROUND: Drug-drug interactions (DDIs) are responsible for a variety of adverse reactions, particularly in an elderly population. OBJECTIVE: To assess the frequency and potential clinical relevance of DDIs in a population aged > or = 55 years. METHODS: Exposure to DDIs was assessed in 7842 people participating in the Rotterdam Study, a population-based cohort study. These people were followed between 1 January 1992 and 1 July 2005. The DDI list of the Royal Dutch Association for the Advancement of Pharmacy, in which DDIs are categorized by potential clinical relevance and quality of evidence, was used. Simultaneous use of interacting drug combinations was calculated on the basis of drug dispensing data from community pharmacies. RESULTS: The incidence of a first dispensing of DDIs in the study period was 10.5 per 100 person-years and 2.7 per 100 person-years for potentially life-threatening DDIs. The prevalence of DDIs in people aged > or = 70 years increased from 10.5% in 1992 to 19.2% in 2005. Ten DDIs comprised two-thirds of the total exposure time to DDIs. The prevalence of potentially life-threatening DDIs in people aged > or = 70 years increased from 1.5% to 2.9%. This increase was most likely caused by an increase in use of spironolactone combined with renin-angiotensin-aldosterone system inhibitors. CONCLUSION: A large number of people in the Netherlands aged > or = 55 years are exposed to DDIs and this number has increased sharply between 1992 and 2005. Healthcare professionals should pay special attention to the potential risks of DDIs in these people, particularly if spironolactone is involved.     

Indigenous Australians who inject drugs: results from a Brisbane study

Injecting drug use by Aboriginal and Torres Strait Islander people has recently generated considerable concern in communities and by public health services and planners. However, there has been almost no research on the use of illicit drugs by indigneous people. This study is the first step in filling this information gap. Through a process of extensive community consultation the important issues were identified and a culturally appropriate research method was developed. A questionnaire was administered by peer interviewers to 77 Aboriginal and Torres Strait Islander peoples who had injected an illegal drug in the past 12 months and who lived in the Brisbane metropolitan area. Speed is the most commonly injected drug but 56% had tried heroin and for about one-third of the sample it was the last drug injected. Sharing injecting equipment is common in this group, with 39% reporting that they had shared a needle in the past month; among participants under 20 years old the percentage rises to 63. Youth and/or inexperience is also associated with unsafe needle disposal and having never personally obtained injecting equipment from a chemist or needle exchange. There is widespread ignorance about safe procedures for cleaning needles. Knowledge about HIV/AIDS is not universal and less than one-quarter personally know someone living with HIV/AIDS; 67% rank their own chances of becoming infected with HIV as very low or low. The results have been used to develop programmes and strategies for harm reduction locally. \[Larson A, Shannon C, Eldridge C. Indigenous Australians who inject drugs: results from a Bristoane study. Drug Alcohol Rev 1999;18:53-62]     

Contested space in the pharmacy: Public attitudes to pharmacy harm reduction services in the West of Scotland

BackgroundInternationally, community pharmacies have become increasingly involved in providing harm reduction services and health advice to people who use illicit drugs.ObjectiveThis paper considers public opinion of community pharmacy services. It discusses attitudes to harm reduction services in the context of stigmatization of addiction and people who use drugs.MethodsThis exploratory study involved twenty-six purposively sampled members of the public, from the West of Scotland, participating in one of 5 focus groups. The groups were composed to represent known groups of users and non-users of community pharmacy, none of whom were problem drug users.ResultsThree thematic categories were identified: methadone service users in community pharmacies; attitudes to harm reduction policies; contested space. Harm reduction service expansion has resulted in a high volume of drug users in and around some Scottish pharmacies. Even if harm reduction services are provided discretely users' behavior can differentiate them from other pharmacy users. Drug users' behavior in this setting is commonly perceived to be unacceptable and can deter other consumers from using pharmacy services. The results of this study infer that negative public opinion is highly suggestive of stereotyping and stigmatization of people who use drugs. Participants considered that (1) community pharmacies were unsuitable environments for harm reduction service provision, as they are used by older people and those with children; (2) current drug policy is perceived as ineffective, as abstinence is seldom achieved and methadone was reported to be re-sold; (3) people who use drugs were avoided where possible in community pharmacies.ConclusionsCommunity pharmacy harm reduction services increasingly bring together the public and drug users. Study participants were reluctant to share pharmacy facilities with drug users. This paper concludes by suggesting mechanisms to minimize stigmatization.     

The prevalence and characteristics of injecting drug users in Australia

The prevalence of injecting drug use has increased significantly in Australia in recent years. Using the nationally representative 1998 National Drug Strategy Household Survey we estimate the size of the lifetime prevalence injecting drug use population at 302710 people, compared to 67474 in 1988. Those who have injected drugs in the previous year are estimated at 108750 people in 1998. Amphetamines have displaced heroin as the most popular drug to inject among the general population. Those who have ever injected are more likely to be male, young, unemployed and to possess fewer educational qualifications. A variety of factors are discussed which may account for increases in injecting drug use. \[McAllister I, Makkai T. The prevalence and characteristics of drug users in Australia. Drug Alcohol Rev 2001;20:29-36]     

Correlates of Trichomonas vaginalis Among Middle Age and Older Adults Who Use Drugs

Background: Recent studies have reported high rates of Trichomonas vaginalis among middle age and older adults. Though trichomoniasis risk factors in this age cohort remain largely unknown, illicit drug use has been associated with increased incidence of sexually transmitted infections (STIs). The number of mid-older adults using illicit drugs has increased significantly in recent years suggesting the need to understand the relationship between drug use and STIs in this age cohort. Objectives: This study examined the relationship between drug use, sexual-risk behaviors, and biologically confirmed T. vaginalis in a sample of mid-older and younger adults who reported recent drug use. Methods: The cross-sectional design examined the relationship between past 6-month drug use, sexual risk-behaviors, and PCR-confirmed T. vaginalis in 264 adults age 18–64 who were recruited from Baltimore, Maryland. These relationships were also explored in the age-stratified sample among those 18–44 years (“younger”) and individuals 45+ years (“mid-older”). Results: Trichomoniasis prevalence did not differ significantly between younger (18.8%) and mid-older (19.1%) adults. Mid-older adults that tested positive for T. vaginalis were more likely to have used marijuana and crack in the past 6 months. Among younger adults, there were no associations between trichomoniasis and past 6-month drug use and sexual-risk behavior. Conclusions/Importance: Age- and drug-related immune decline is hypothesized to contribute to increase susceptibility to T. vaginalis in mid-older adults. Broad screening for trichomoniasis, particularly among older adults who are often not regarded as at risk for STIs, is needed to control this often asymptomatic infection.