2006-2015年广州市社区美沙酮维持治疗状况分析

Analysis of methadone maintenance treatment status in Guangzhou:2006-2015

目的描述2006-2015年广州市社区美沙酮维持治疗开展状况,分析存在问题,提出科学建议,为促进美沙酮维持治疗工作提供依据。方法从＂社区美沙酮信息系统＂中,提取2015年9月30日之前广州市美沙酮维持治疗门诊治疗人员的一般情况、吸毒情况及治疗相关变量等信息,运用R 3.2.3进行描述性分析。结果2006-2015年,广州市美沙酮门诊累计登记治疗4974人,平均稳定剂量为51.36mg/日。2006到2009年稳定服药剂量持续增长,自2009年起,剂量稳定于50~55mg/日,市辖区内门诊稳定剂量高于郊区门诊。截至2015年,所有入组治疗吸毒者的脱失率为68.9%;入组后首年脱失率最高为33.8%,郊区门诊脱失率及首年脱失率均高于市辖区。结论广州市美沙酮维持治疗存在脱失率高,服药剂量低等问题,其中郊区脱失更为严重,且服药剂量更低,需进一步扩大美沙酮维持治疗覆盖面,提高服务可及性,增加治疗剂量,保证治疗者良好的治疗依从性。

Objective To describe the use of methadone maintenance treatment（MMT）in Guangzhou from 2006 to 2015,and to explore the existing problems,in order to improve implementation of MMT program.Methods Data were collected from the national MMT information management system from Sept 30,2006 to Sept 30,2015 including MMT users＇ demographic status,drug abuse behaviors and MMT clinical records.All data analyses were performed by statistical software R version 3.2.3.Results A total of 4974 drug users were registered for MMT since 2006.The average maintenance dose of MMT was 51.36mg/d.The doses kept increasing from 2006 to 2009and became steady after 2009.The doses of urban MMT clinics were higher than those of suburb clinics.Of all participants,the dropout rate was 68.9% by 2015 and 33.8% dropped out during the first year of the treatment.The dropout rates of suburb MMT clinics were higher than those of urban clinics.Conclusion The MMT dropout rate is high and the dosage is low in Guangzhou,and the situation is even worse in the suburb clinics.We suggest to expand the coverage and accessibility of MMT,and to improve the treatment adherence.