新疆部分海洛因成瘾者社区药物维持治疗门诊药物维持治疗综合效果评估

Effective Evaluation on Parts of Community-based Methadone Maintenance Treatment Clinics for Heroin Addicts in Xinjiang

目的初步评价新疆已运行6个月、12个月海洛因成瘾者社区药物维持治疗门诊,在减少毒品危害预防艾滋病中发挥的综合效果。方法根据社区药物维持治疗工作评估方案要求,对新疆12个门诊开诊后2个月内新参加维持治疗病人进行了基线调查,3个开诊后满6个月、2个开诊后满12个月门诊的参加服药人员进行了高危行为、违法犯罪行为、社会家庭功能、有关疾病感染情况等4方面调查,以反映维持治疗促进吸毒者行为发生向好的方面转变,阐述维持治疗的效果。结果吸毒者服药前后毒品滥用次数有非常明显下降,且共用针具下降尤其明显,服药人员服药后安全套使用率也有一定程度提高,与既往毒友往来大幅度减少,与家庭成员关系明显改善,就业机会有一定程度增加,同时还极大地降低了服药人员艾滋病感染机会。结论社区药物维持治疗是应用合法、安全的美沙酮药物替代正在使用毒品的一种综合性的治疗方法。这种方法能减少吸毒人员毒品使用、静脉注射毒品和共针现象的发生,能大幅度减少艾滋病经共用针具传播,同时还可以减少各种违法犯罪,促进服药人员回归社会,改善生活质量,是一种非常有效地减少毒品危害、预防艾滋病的手段。

Objective To assess the effectiveness of community-based methadone maintenance treatment（MMT） clinics for heroin addicts（run for 12 months） in drug-related harm reduction and HIV/AIDS prevention and control.Methods Based on the evaluation plan on MMT,a baseline survey among heroin addicts participated in 12 MMT clinics were conducted at the beginning of the clinics,and the surveys of the HIV/AIDS related high-risk behaviors,criminal behaviors,functions in society and family and infective situation of relevant diseases among the heroin addicts were carried out respectively in the third months of 3 clinics and 12 months of 2 clinics.The effectiveness of MMT was assessed through comparing the results of the surveys.Results Times of illegal drug use and needle sharing behavior among the clients of MMT clinics reduced markedly;clients＇ condom use rate increased to some extent;contact with past illegal drug use group reduced to a large degree;relationships with family members and employment status improved;accordingly,the risk for HIV infection among the clients reduced obviously.Conclusions MMT not only reduces heroin use,injecting drug use and needle sharing and HIV spread,but also plays a positive role in reducing drug-related crimes and improving client＇s social function and life quality.MMT is an effective measure for harm reduction and HIV/AIDS prevention and control,and therefore the measure should be expanded on a large scale.