社区戒毒康复人员美沙酮维持治疗认知及治疗意愿分析  

Cognitive function and willingness toward methadone maintenance treatment among community rehabilitation addicts

作　　者：黎健荣 潘丝媛 李艳[1] 徐慧芳 李健强 李杰[1] 刘优招 陈柳言 杨放[1] LI Jianrong;PAN Siyuan;LI Yan;XU Huifang;LI Jianqiang;LI Jie;LIU Youzhao;CHEN Liuyan;YANG Fang(Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,Guangdong,China;Guangdong Association for STD and AIDS Prevention and Control,Guangzhou 511430,Guangdong,China;Big Dipper Social Work Service Center of Guangzhou,Guangzhou 510160,Guangdong,China)

机构地区：[1]广东省疾病预防控制中心,广州511430 [2]广东省性病艾滋病防治协会,广州511430 [3]广州市北斗星社会工作服务中心,广州510160

出　　处：《中国艾滋病性病》2025年第3期299-304,共6页Chinese Journal of Aids & STD

基　　金：广东省医学科研基金项目(B2020174)。

摘　　要：目的了解社区戒毒康复人员对美沙酮维持治疗(MMT)认知和治疗意愿。方法采用方便抽样的方法收集社区戒毒社区康复机构阿片类吸毒人员信息,分析其对MMT认知、治疗意愿及相关因素;通过定性访谈,基于健康信念模型进一步探讨其不愿意治疗的原因。结果共调查503人,有MMT意愿的比例为7.6%(38/503)。多因素Logistic回归分析结果显示,有强戒史者(相较于无强戒史者,OR=0.258,95%CI:0.105~0.633)有MMT意愿的概率更低,而有MMT史者(相较于无MMT史者,OR=3.373,95%CI:1.647~6.908)、认同美沙酮长期维持治疗更有效者(相较于不认同/不知道者,OR=3.221,95%CI:1.543~6.723)有MMT意愿的概率更高。不愿意参加MMT的原因中,认为可以完全靠自己戒毒的占比最高,为59.8%(278/465)。共访谈52名无MMT意愿者,部分访谈对象认为已在强戒所戒断毒瘾从而不需要服用美沙酮;进一步分析发现,在不愿意参加MMT的原因中,认为可以完全靠自己戒毒是最主要原因,其次是主观判断认为MMT不良反应多、更难戒断、是小毒代大毒等。结论广东省社区戒毒康复人员MMT意愿较低,与其对MMT认知有关,需针对性加强宣教干预。建议适时探索美沙酮社区脱毒治疗方式,在理念和工作上与MMT、强戒和社区戒毒康复衔接。Objective To understand the cognitive function and willingness toward methadone maintenance treatment(MMT)among community rehabilitation addicts.Methods Data on opioid addicts in community rehabilitation institutions were collected using a non-probability sampling method.Perceptions,willingness,and factors influencing MMT participation were analyzed.The reasons for reluctance to undergo MMT were further explored through qualitative interviews based on the Health Belief Model.Results A total of 503 addicts were surveyed,of whom 7.6%(38/503)expressed willingness to undergo MMT.Multivariate logistic regression analysis showed that the probability of MMT willingness was lower among addicts with a history of isolated compulsory detoxification than those without(OR=0.258,95%CI:0.105-0.633).Conversely,the probability of MMT willingness was higher among addicts with a history of MMT than those without(OR=3.373,95%CI:1.647-6.908).Additionally,addicts who agreed that methadone as a long-term maintenance treatment is effective exhibited a higher probability of MMT willingness than those who disagreed or did not know(OR=3.221,95%CI:1.543-6.723).Among those unwilling to receive MMT,the most frequently cited reason was their belief that they could quit drugs completely by themselves(59.8%,278/465).A total of 52 addicts were interviewed,and the results of the analysis showed that some of the interviewees believed that they had already achieved detoxification in isolated compulsory detoxification institutions and did not need to take methadone.Further analysis revealed that the primary reason for unwillingness to undergo treatment was the belief in the ability to quit drugs independently.This perception was a subjective judgment influenced by views on MMT,including concerns about increased adverse reactions,greater difficulty in detoxification,and the notion that methadone merely substitutes a minor drug with a larger one.Conclusions The low willingness to undergo MMT among community-based drug rehabilitators is related to their

关 键 词：社区戒毒康复 美沙酮维持治疗 认知 意愿 健康信念模型 

分 类 号：R512.91[医药卫生—内科学]