美沙冬替代療法對於海洛因成癮者藥物濫用信念及生活適應之成效分析 The Effectiveness of Methadone Maintenance Treatment on Beliefs about Drug Abuse and Life Adjustment among Heroin Addicts
台灣公共衛生雜誌:29卷5期(2010 / 10 / 01) ，P420 - 430
中文摘要
目標：台灣近年來愛滋病感染人數急遽增加，衛生署於2005年12月開始推動「毒品病患愛滋減害試辦計畫」，美沙冬替代療法(methadone maintenance treatment)得以由國外引進台灣。本研究以介入組及比較組的前瞻性研究設計，探討美沙冬替代療法對於海洛因成癮之治療成效。方法：介入組為於某區域醫院精神科門診接受美沙冬替代療法之海洛因成癮者(n=67)，比較組為因違反毒品危害防制條例於某地檢署接受保護管束處分之海洛因成癮者(n=21)。兩組分別以濫用藥物信念量表及社區生活適應量表進行前測及後測，前後測間隔時間為三個月。結果：統計方法以重複量數雙因子變異數分析進行，結果顯示美沙冬替代療法之介入，可改善海洛因成癮者之藥物濫用信念偏差及其生活適應功能。結論：海洛因成癮後戒除不易，極易復發，個案常有多次毒品前科。建議政府相關單位應持續編列預算補助「美沙冬替代療法」，以降低進入治療的門檻及提高治療的普及率為目標，方能建立遠離毒害的健康社會。
Abstract
Objectives: Recently, the number of HIV-infected cases in Taiwan has increased dramatically. The Department of Health promoted ”AIDS Harm Reduction in Drug Abusers: A Pilot Project”, which incorporated methadone maintenance treatment, a concept brought into Taiwan from abroad. This prospective study was conducted with heroin addicts in an intervention and a comparison group to evaluate the therapeutic effectiveness of methadone maintenance treatment on beliefs about drug abuse and life adjustment. Methods: The intervention group was composed of heroin addicts receiving methadone maintenance treatment in the department of psychiatry of a regional hospital (n=67). The comparison group was composed of heroin addicts placed under probation in a district prosecutor's office due to violation of the Drugs Hazard Control Act (n=21). The two groups were evaluated with ”beliefs about drug abuse” and ”life adjustment” questionnaires before and after three-months of treatment. Results: A repeated measures two-way ANOVA was conducted to compare the intervention and comparison groups. The results demonstrated that methadone maintenance improved beliefs about drug abuse and life adjustment in heroin addicts. Conclusions: Heroin abstinence is extremely difficult after a person becomes addicted. Relapses are frequent and may result in multiple drug convictions. We suggest that the government allocate a budget for methadone maintenance treatment to lower the threshold for admission to a program and to increase popularization of the treatment. We can achieve a society without drugs.
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