立陶宛的美沙酮维持治疗:面临的挑战、解决办法及艾滋病治疗与关怀整合(英文)

METHADONE MAINTENANCE TREATMENT OF OPIOID DEPENDENCE IN LITHUANIA:CHALLENGES,SOLUTIONS AND INTEGRATION WITH HIV/AIDS TREATMENT AND CARE

在过去的10年里,注射毒品是艾滋病病毒(HIV)在东欧和立陶宛传播的主要途径。阿片类是该地区注射滥用最多的非法毒品。立陶宛于1995年开始开展美沙酮维持治疗,是在注射毒品者中发现第一例HIV者之前。美沙酮维持治疗的引入和10年开展美沙酮维持的实践遇到了很多的挑战。为了应对美沙酮维持给社区带来的不良影响和阻止美沙酮转入非法市场采用了不同的策略。最近的一次挑战是将HIV/AIDS治疗整合到提供美沙酮维持治疗的专科精神卫生/依赖医院,以提高美沙酮维持治疗的效果。委托自助小组帮助美沙酮维持治疗者的策略也在讨论中。

Injecting drug use was the main route of transmission of HIV in Eastem Europe and Lithuania for the last decade. The most prevalent injected illegal drugs in the region were opioids. Methadone maintenance treatment （MMT） started in Lithuania in 1995 before the first HIV cases were recorded among IDUs. Introduction and 10 years of implementation of MMT has been followed by many challenges. Different strategies were used to counter adverse effects of MMT on the neighbourhood and cases of diversion of methadone to illegal market. Among the most recent challenges for the programs is the improvement of the quality of MMT programs, including integration of HIV/AIDS care into specialized mental health/dependence institutions providing MMT. Strategies used to empower MMT patients in Lithuania through self help groups are also discussed.