海洛因依赖者环境线索诱发心理生理反应

Psycho-physiological reactions to heroin-related cues in heroin dependent patients

目的:了解海洛因依赖者对吸毒相关环境线索诱发反应。方法:对来自自愿戒毒机构的36例刚完成生理脱毒(康复早期)的海洛因依赖者和劳教戒毒机构112例康复期满1年的海洛因依赖者观看吸毒相关视频同时给予海洛因模拟物及吸毒用具刺激,于暴露前后自评渴求程度、情绪以及戒断症状反应;用生物反馈仪自动记录暴露前后的生理反应。结果:环境线索暴露后海洛因依赖者心理渴求、害怕/焦虑、抑郁/悲伤、戒断症状、心率、皮肤导电和肌电增高(P<0.05),中性/放松/自然降低(P<0.05)。自愿戒毒机构康复早期海洛因依赖者环境诱发心率增高,比康复期满一年以上者更明显(P<0.05),其余与康复期长短无显著关系。结论:海洛因依赖者戒断康复期的延长并不会使渴求和环境诱发心理生理反应减弱或消褪。

Objective ：To understand the reactions to circumstance cues related with heroin in patients with heroin dependence. Method：In the self-controlled study,36 heroin addicts came from the voluntary detoxification center and just completed the detoxifieation（ early abstinence） , and 112 heroin addicts from the reeducation rehabilitation and had completed the detoxification for at least 1 year. All the subjects were exposed to videotapes about drug abuse and related simulacrum after self-relaxation. The degree of craving for heroin,emotion and withdraw symptoms were evaluated by the subjects, and the psycho-physiological reactions were measured by biofeedback instrument before and after exposures. Results：After cue exposures ,the indexes of craving, fear/anxiety, depression/sadness, withdraw symptoms, heart rate, skin conduction, and electromyogram increased （ P 〈 0.05 ）, but those of neutral, relaxation and natural decreased （ P 〈 0.05 ）. No significant differences were found in the reactions between voluntary detoxification hospital and re-education institution（ P 〉 0.05 ） ,except the increase of heart rate. Conclusion：It is suggested that prolonging the duration of abstinence therapy might not decrease the degree of craving for drug and psycho-physiological reactions under related exposures.