社会工作者介入美沙酮维持治疗综合干预服务模式初探

目的探讨广州市社会工作机构介入美沙酮维持治疗（MMT）干预服务模式的适宜性和有效性，为其他地区提供借鉴。方法依托MMT门诊的驻点社工，构建广州市MMT社工干预服务模式，收集并比较分析开展和未开展社工干预服务的门诊的受治者，在治疗依从性、毒品偷吸等行为、与家庭关系等方面的差别情况。结果随着MMT门诊社工服务模式的建立和不断完善，与没有开展社工服务的门诊相比，有社工服务的门诊的受治者治疗脱失率较低（21.03％VS58.68％,χ^2=98.730，P〈0.001），新人组受治者12个月尿检阳性率呈逐步下降的趋势（χ^2=293.378，P〈0.001），受治者与家庭关系较差的比例较低（2.22％vs7.66％,χ^2=10.186，P〈0.001），自述存在毒品偷吸行为的比例较低（7.96％VS25.74％，χ^2=45.985，P〈0.001）。与开展社工服务前相比，HIV阳性受治者治疗脱失率显著降低（14.57％VS43.02％，χ^2=13.688，P〈O.001）。结论社会工作机构介入MMT干预服务模式具有适宜性和有效性，能有效提高MMT的效益，此经验可为广东省乃至全国其他地区提供参考。

Exploration of social workers involvement in intervention services for methadone maintenance treatment

Objective To investigate the feasibility and effectiveness of involving social workers in intervention services for methadone maintenance treatment （MMT） clinics in Guangzhou, and to provide reference for other re- gions. Method A model of integrated intervention services depending on social workers at MMT clinics was estab- lished. Differences in retention rate, relapse rate, family relationships, etc. among MMT clinics attendants with and without social workers involvement were compared. Results As compared with MMT clinics without social worker involvement in intervention service, the clinics with social worker involvement had lower dropout rates （21.03% vs 58.68%, χ^2=98. 730,P〈0.001） among the attendants, the positive rates of urine testing in 12 months among the new attendants was decreasing （χ^2=293. 378, P〈0. 001）, the proportion of poor family relationship was lower （2.22% vs 7.7%, χ^2= 10. 186,P%0.001） and the rates of heroin relapse was lower （7.96% vs 25.74%, χ^2=45.985,P%0.001）. HIV positive MMT attendants also decreased dropout rates due to the social workers% service （14.57%% vs 43.02%, χ^2=13.688,P%0.001）. Conclusion The model of involving social workers in intervention service is applicable in MMT clinics to promote the effectiveness. The experience can be utilized by other places of Guangdong and other regions of China.