美沙酮维持治疗患者脱失原因及脱失后现状调查

The Dropout Causes and the Status After Dropout of Methadone Maintenance Treatment Patients

目的:探究美沙酮维持治疗患者的脱失原因,了解美沙酮维持治疗患者脱失后的状况,为降低美沙酮维持治疗脱失率提供依据。方法:用自制调查表对102名曾经在广州市广州医科大学附属脑科医院美沙酮治疗门诊治疗且目前处于脱失状态的患者进行脱失原因及脱失后焦虑、抑郁、渴求状况和吗啡尿检结果进行调查。结果:102名受访者中,因“自认为戒断而退组”的有55人,占比54.0%;因“偷吸而被强制隔离戒毒”的有34人,占比33.3%;因“与毒品无关的违法被抓”的有7人,占比6.9%;因“疾病”原因退出的有5人,占比4.9%;因其他原因退出的1人,占比1%。在102人中有2人吗啡尿检结果阳性,占比2%;有11人对阿片类物质仍存在不同程度的渴求,占比10.8%;有26人存在抑郁症状,占比25.5%;有21人存在焦虑症状,占比20.6%。结论:自我认知不充分、因违法犯罪被抓而脱离治疗是美沙酮维持治疗患者脱失的关键原因。相当一部分脱失者退出治疗后渴求状况、焦虑情绪、抑郁情绪等的方面的变化也是较为明显的,这些现象都需要加以关注及采取必要的早期干预。

Objective:To investigate the dropout causes and the status after dropout of methadone maintenance treatment patients,and to provide practical basis for reducing the dropout rate of methadone maintenance treatment.Methods:A total of 102 MMT dropout patients from the Affiliated Brain Hospital of Guangzhou Medical University were investigated with self-made questionnaire.The information such as the causes of dropout,anxiety status,depression status,craving status and the result of morphine urine test were collected.Results:Among the 102 subjects,54.0%dropped out of MMT because of self-aware of no-need for drugs,33.3%because of arrested for drug-related violating behaviors,6.9%because of arrested for non-drug related crimes,4.9%due to health conditions,1%due to other causes.2 subjects showed positive urine morphine test.There were 11 subjects still had different degree of craving for opioids.There were 26 subjects with depressive symptoms,and 21 subjects with anxiety symptoms.Conclusion:The key reasons of dropout are inadequate self-cognition and being arrested for crimes.After dropout from treatment,quite a few of the patients had obvious changes in craving,anxiety and depression.These phenomena need to be noticed,and the early intervention is essential.