Factors associated with abstinence, lapse or relapse to heroin use after residential treatment: protective effect of coping responses
Factors associated with abstinence, lapse or relapse to heroin use after residential treatment: protective effect of coping responses
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DOI：
10.1046/j.1360-0443.2002.00227.x
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发表时间：
2002-10-01
期刊：
影响因子：
6
通讯作者：
Marsden, J
中科院分区：
文献类型：
--
作者：
Gossop, M;Stewart, D;Marsden, J
本研究旨在探讨住院治疗后海洛因戒断、滥用或复发的相关因素，特别是认知、回避和分心应对反应的改变与海洛因使用及其他吸毒结果的关系。设计、背景、对象来自NTORS项目23个居住项目的242名患者，他们在治疗前使用过海洛因，并在治疗后的前12个月内进行了跟踪。通过结构化的面对面访谈收集了患者的特征和问题、应对反应、药物使用和其他结果的测量数据。发现许多患者(60%)在治疗后使用海洛因，第一次使用海洛因通常发生在结束治疗后不久：40%的人仍然戒除海洛因。根据海洛因的结果状态(戒断、失效、复发)对三组进行了分析。避免海洛因完全复发的客户(戒毒组和流失组)在随访中始终比在吸食时更多地使用认知、回避和分心应对策略。治疗完成与较好的结果相关。吸毒组和复吸组治疗后吸食海洛因以外的其他违禁药物的比例高于戒毒组。结论尽管吸毒效果总体上令人满意，但吸食海洛因的复吸和复吸仍值得关注。治疗服务应进一步发展，并加强药物滥用者的复发预防和应对技能。
Aims This study investigates factors associated with abstinence, lapse or relapse to heroin use after residential treatment and, specifically, the extent to which changes in cognitive, avoidance and distraction coping responses were related to heroin use and other drug use outcomes.Design, setting, participants The sample comprised 242 clients from 23 residential programmes in the NTORS project, who used heroin before treatment and who were followed-up after treatment during the first 12 months of the study.Measurements Data on client characteristics and problems, coping responses, drug use and other outcomes, were collected by structured face-to-face interviews.Findings Many clients (60%) used heroin after treatment, with the first occasion of heroin use usually occurring very soon after leaving treatment: 40%) remained abstinent from heroin. Analyses were conducted for three groups based upon heroin outcome status (abstinent, lapsed, relapsed). Clients who avoided a full relapse to heroin use (abstinent and lapse groups) consistently made more use of cognitive, avoidance and distraction coping strategies at follow-up than at intake. Treatment completion was related to better outcome. The lapse and relapse groups reported higher rates of use of illicit drugs other than heroin after treatment than the abstinent group.Conclusions Despite generally satisfactory drug use outcomes, the lapses and relapses to heroin use give rise to concern. Treatment services should develop further and strengthen relapse prevention and relapse coping skills among drug misusers.