CAJ | 학술논문

目的了解海洛因依赖者戒毒回归社会后1年内药物滥用的结局与转归,分析海洛因依赖者戒断后1年复吸的预后因素.方法使用自制个案调查表、应激感觉量表(PSS)和成瘾行为严重度指数量表(ASI)对563例回归社会后1年的海洛因依赖者进行访谈评估,并使用自然病程问卷(NHI)跟踪随访1年内复吸发生情况,对操守时间进行生存分析.结果共249例完成1年随访面谈,其中发生复吸者为111例(44.6％),平均操守时间为(8.3±0.3)个月；复吸者心理渴求程度[(3.69±3.60)分∶(0.40±1.46)分；P＜0.01]、PSS评分[(19.0±4.7)分∶(17.6±4.6)分；P＜0.05]及ASI的躯体状况[0.00(0.00 ～0.33)分∶0.00(0.00 ～0.02)分；P＜0.01]、就业状况[(0.83±0.27)分∶(0.67±0.30)分；P＜0.01]、毒品使用状况[0.14(0.00 ～0.25)分∶0.00(0.00 ～ 0.00)分；P＜0.01]、酒精滥用情况[0.00(0.00 ～0.08)分∶0.00(0.00 ～0.00)分；P＜0.05]、法律状况[(0.00(0.00 ～0.05)分∶0.00(0.00 ～0.00)分；P＜0.01]、家庭支持[0.13(0.04 ～0.26)分∶0.10(0.00 ～0.18)分；P＜0.01]和精神状况[0.00(0.09 ～0.36)分∶0.00(0.00 ～0.00)分；P＜0.01]因子分均高于操守者；Cox回归分析显示,基线心理渴求程度是复吸的危险因素(OR=1.226,P＜0.01).结论海洛因依赖者戒毒后回归社会后1年内发生复吸行为比例高,有无发生复吸的海洛因依赖者具有不同的临床特征,降低毒品的心理渴求程度可降低回归社会后复吸的风险.
목적 료해해락인의뢰자계독회귀사회후1년내약물람용적결국여전귀,분석해락인의뢰자계단후1년복흡적예후인소.방법 사용자제개안조사표、응격감각량표(PSS)화성은행위엄중도지수량표(ASI)대563례회귀사회후1년적해락인의뢰자진행방담평고,병사용자연병정문권(NHI)근종수방1년내복흡발생정황,대조수시간진행생존분석.결과 공249례완성1년수방면담,기중발생복흡자위111례(44.6％),평균조수시간위(8.3±0.3)개월；복흡자심리갈구정도[(3.69±3.60)분∶(0.40±1.46)분；P＜0.01]、PSS평분[(19.0±4.7)분∶(17.6±4.6)분；P＜0.05]급ASI적구체상황[0.00(0.00 ～0.33)분∶0.00(0.00 ～0.02)분；P＜0.01]、취업상황[(0.83±0.27)분∶(0.67±0.30)분；P＜0.01]、독품사용상황[0.14(0.00 ～0.25)분∶0.00(0.00 ～ 0.00)분；P＜0.01]、주정람용정황[0.00(0.00 ～0.08)분∶0.00(0.00 ～0.00)분；P＜0.05]、법률상황[(0.00(0.00 ～0.05)분∶0.00(0.00 ～0.00)분；P＜0.01]、가정지지[0.13(0.04 ～0.26)분∶0.10(0.00 ～0.18)분；P＜0.01]화정신상황[0.00(0.09 ～0.36)분∶0.00(0.00 ～0.00)분；P＜0.01]인자분균고우조수자；Cox회귀분석현시,기선심리갈구정도시복흡적위험인소(OR=1.226,P＜0.01).결론 해락인의뢰자계독후회귀사회후1년내발생복흡행위비례고,유무발생복흡적해락인의뢰자구유불동적림상특정,강저독품적심리갈구정도가강저회귀사회후복흡적풍험.
Objective To examine the drug use pattern of detoxificated heroin addicts after 1 year from return to society after detoxification,and to identify predictors of relapse.Methods 563 heroin addicts were accessed by case questionnaire and the Perceived Stress Scall(PPS),Addiction Severity Index (ASI),and followed after 1 year by the Nature History Interview (NHI) from return to society after detoxification."Relapse" was defined as any heroin use during 1 year after detoxification.Survival analysis were used to examine the drug use pattern and to identify the predictor of relapse.Results There were 111 cases (44.6％) had heroin use during observation period among 249 cases who completee 1 year follow-up.Survival analysis showed that the average maintaining abstinence time was (8.3 ± 0.3) months.Relapsed and non-relapsed addicts presented different craving degree (3.69 ±3.60 vs.0.40 ± 1.46,P ＜0.01),PSS scores (19.0 ± 4.7 vs.17.6 ± 4.6,P ＜ 0.05),physical condition dimension score [0.00 (0.00-0.33)vs.0.00(0.00(0.00-0.02),P ＜0.01],employment dimension score (0.83 ±0.27 vs.0.67 ±0.30,P ＜ 0.01),alcohol problem dimension score [0.00 (0.00-0.08) vs.0.00 (0.00-0.00)],P ＜ 0.05],drug problem dimension score [0.14 ± (0.00-0.25) vs.0.00 (0.00-0.00),P ＜0.01],legal problems dimension score [0.00 (0.00-0.05) vs.0.00 (0.00-0.00),P ＜ 0.01],family status dimension score [0.13(0.04-0.26) vs.0.10(0.00-0.18),P ＜0.01],mental health dimension score [0.09(0.00-0.36) vs.0.00(0.00-0.00),P ＜ 0.01] at follow-up interview.Cox regression analysis results showed that the craving degree during the past one month at baseline was a risk factor related to relapse (OR =1.226,P ＜ 0.01).Conclusion The proportion of detoxificated heroin addicts during 1 year from return to society occur relapse is higher,and relapsed heroin addicts probably present different clinical characteristics in camparison with non-relapsed ones.