影响海淀区美沙酮社区药物维持治疗门诊利用的因素研究

目的了解影响北京市海淀区美沙酮社区维持治疗服务利用的因素,提出改进措施。方法选取海淀区162名美沙酮门诊在治人员,105名退出治疗人员,120未入组治疗的社区吸毒人员进行问卷调查,选取16名在治人员、5名门诊工作人员、5名社区民警进行个人深入访谈。结果年龄、有无工作、婚姻状态以及药物滥用对参加入组有影响,差异有统计学意义（P〈0.05）;担心被警察抓（50.4%）、担心副作用（22.3%）、美沙酮成瘾（11.0%）、疗效不佳（7.4%）、门诊开诊时间不方便（3.9%）是影响入组和治疗的5大因素;社区/媒体宣传（55.8%）、吸毒朋友介绍（33.9%）、非吸毒亲朋介绍33（8.5%）位居最有效宣传途径的前3位。退出的原因顺位是强戒劳教、违法犯罪、原因不明、工作外出、违反规章制度、死亡。结论影响美沙酮门诊利用的因素是多方面的,增加入组人数需要根据吸毒人员情况制定个性化治疗方案,提高公安部门的认识,加强同家属、公安部门的沟通协作,完善激励机制,提高政府的重视程度。

Survey on Factors Influencing the Acceptance of Methadone Maintenance Treatment in Haidian District of Beijing

Objective To investigate the factors influencing the acceptance of methadone maintenance treatment in Haidian District of Beijing; and thereby to explore the improving measures. Methods 162 current participants and 105 former participants in Haidian Methadone Maintenance Clinic, and 120 drug addicts who did not take methadone maintenance treatment were selected for the survey, and were asked to answer questionnaires. 16 current participants, 5 clinic physicians and 5 community policemen were asked to accept in-depth interviews individually. Results Age, job, marriage status and drug abuse could significantly influence on the acceptance of methadone maintenance treatment （ P 〈 0. 05 ）. The first five factors influencing the participation in methadone maintenance treatment were fear to be caught by police （50.4%）, the worries of side effects （22. 3% ）, methadone addiction （ 11.0% ）, unsatisfying with curative effects （7.34%）, and the inconvenient of clinic time （3.9%）. And the most powerful promoting approaches were community/media dissemination （55.8%）, introduction by other drug addicts （33.9%） and introduction by other friends （8. 5% ）. The reasons for withdrawing from methadone maintenance treatment were listed as being forced to abstain from drug at labor camp, breaking law or being committed crimes, reason unknown, business trip, breaking the rules and regulations of the clinic and death. Conclusion There were many different factors influencing the acceptance of methadone maintenance treatment. In order to increase the participants in clinic, we should establish individualized treatment program, increase the support of police, enhance the communication with relatives and police, improve incentive system and draw the attention of government.