社区海洛因依赖者美沙酮维持治疗的效果评估

目的:探讨美沙酮维持治疗在中国实施的可行性和有效性。方法:对海洛因依赖者开展美沙酮维持治疗试验性项目并定期开展小组心理干预、个别心理咨询和相关的支持活动。项目实施1a后,采用自制问卷对美沙酮维持治疗前后的效果进行评估,并将结果与37名社区海洛因依赖者进行比较。结果:美沙酮维持治疗后,维持者自我报告使用海洛因的比例由治疗前的100·0%下降为64·4%,其中,每天使用3次以上海洛因者由维持治疗前的50·0%降为0;对照组为43·2%。维持者的总违法犯罪率与维持治疗前和对照组比较,分别下降了4·6%和15·3%。维持者以注射方式吸毒的比例显著低于项目开展前和对照组(P<0·01),而从不使用安全套的比例明显少于项目前和对照组(P<0·01)。结论:在我国的海洛因依赖者中开展美沙酮维持治疗对于减少非法毒品的使用,降低违法犯罪率和减少感染艾滋病的高危行为是有效的。

EVALUATION OF COMMUNITY-BASED METHADONE MAINTENANCE TREATMENTFOR HEROIN DEPENDENT PATIENTS

Objective: To evaluate the effectiveness of community-based methadone maintenance treatment (MMT) for heroin dependent patients in Yunnan Province. Methods: MMT combined with group counseling activities was implemented among heroin dependent patients. One year later, an evaluation was conducted on the effectiveness of MMT with a self-designed questionnaire. The result was compared with that of 37 current heroin users in the community. Results: After implementing the project for one year, the relapse rate in MMT group decreased from 100.0% to 64.4%. The rate of using heroin 3 times a day decreased from 50.0% before MMT to zero, and the rate in the control was 43.2%; and the rate of criminal offences decreased 4.6%, and 15.3%lower than those of the control group. Compared with the control, the rate of injecting drug and never using condom reduced significantly too(P<0.01). Conclusion: MMT in China can reduce the demand of drugs, injecting drug use, criminal offences and prevent the spread of HIV/AIDS.