社区美沙酮维持治疗对海洛因成瘾者吸毒行为影响的初步研究

On the Impact of Community-based Methadone Maintenance Treatment Among Drug Addicts

目的 了解四川省西昌市社区美沙酮维持治疗对海洛因成瘾者吸毒行为的影响情况。方法于2004—05／07，以社区为基础招募海洛因成瘾者，调查其社会人口学、毒品使用及共用注射器具行为特征，了解社区美沙酮维持治疗（MMT）对吸毒行为的影响情况。结果 在调查的海洛因成瘾者中参加过MMT的为30．4％（105／346），参加MMT时间的中位数为49d。在控制社会人口学等因素后，多因素Logistic分析结果显示，MMT与海洛因成瘾者近3个月吸毒行为的关系有统计学意义的变量为：静脉吸毒频率（OR：0．40；95％CI：0．24～0．66）、海洛因口吸频率（OR：3．06；95％CI：1．87～5．00）、海洛因混合其他毒品使用频率（OR：0．43；95％CI：0．26～0．73）、共用针头或注射器（OR：0．03；95％CI：0．01-0．13）、共用洗针头或注射器用水（OR：0．06；95％CI：0．01～0．24）和共用吸毒器皿（OR：0．02；95％CI：0．00～0．18）。结论 研究结果表明我国第一批海洛因成瘾者美沙酮维持治疗试点项目在减少吸毒人群毒品使用和艾滋病相关高危吸毒行为等方面具有明显的效果。

Objective To investigate the impact of community- based methadone maintenance treatment on drug use among heroin addicts in Xichang of Sichuan province. Methods From May to July 2004, a community - based survey was conducted to collect socio - demographics, behavioral trait of drug use and sharing of injection equipments among drug users. Results Among the total 346 heroin addicts investigated, 30.4 % （ 105/346） had taken part in methadone maintenance treatment and the median treatment duration was 49 days. After controlling socio- demographics and other potential confounding factors, multivariate logistic regression model showed that MMT had statistical significance with frequency of IV drug use （OR, 0.40; 95 % CI, 0.24 - 0.66）, frequency of sniffing heroin （OR, 3.06; 95%C1, 1.87-5.00）, frequency of using heroin plus other drugs （ OR, 0.43 ; 95 % CI, 0.26 - 0.73 ）, sharing needles or injection syringes （OR, 0.03; 95%CI, 0.01-0.13）, sharing water of washing needles or injection syringes （ OR, 0. 06 ; 95 % CI, O. O1 - 0. 24） and sharing containers for drug use（OR, 0.02; 95% CI, 0.00- 0.18）in the past 3 months among heroin addicts. Conclusions This study showed the pilot project of methadone maintenance treatment carried out among the first group of heroin addicts in China had significant efficacy in reducing drug use and high - risk drug use behaviors related to HIV/AIDS.