Consequences and costs of shutting off methadone.
Consequences and costs of shutting off methadone.
复制标题
停止美沙酮的后果和费用。
DOI：
10.1016/0306-4603(89)90062-2
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发表时间：
1989
影响因子：
4.4
通讯作者：
Ryan,TM
中科院分区：
文献类型：
--
作者：
Anglin,MD;Speckart,GR;Booth,MW;Ryan,TM
面对日益高涨的财政保守主义，许多吸毒人口众多的州和地区已经减少或取消了美沙酮维持（MM）计划的公共资金，并允许私人收费服务计划来取代它们。参考加州的经验，分析了这些资助政策变化的社会和经济成本。对圣地亚哥 MM 客户（195 名男性，129 名女性）终止公共补贴计划的样本进行了两年半的随访，将其结果与奥兰治县、河滨县和圣贝纳迪诺县公共资助的 MM 计划的客户（129 名男性，131 名女性）的结果进行了比较。在二次分析中，对转入私人（按服务收费）治疗计划的圣地亚哥客户与未转入的客户进行了比较。对于无法或不愿意转入私人项目的客户，我们发现了主要的不利后果：未转入的客户表现出较高的犯罪率和交易率、与刑事司法系统的更多接触以及较高的非法药物使用率。此外，MM项目成本减少所节省的成本几乎被监禁、法律监督和其他政府资助的戒毒治疗直接成本的增加所抵消。未评估间接成本。
In the face of rising fiscal conservatism, many states and localities with sizable addict populations have reduced or eliminated public funding for methadone maintenance (MM) programs and permitted private-fee-for-service programs to replace them. The social and economic costs of these changed funding policies with reference to the California experience were analyzed. A two-and-a-half year follow-up of a sample of San Diego MM clients (195 men, 129 women) terminated from a public subsidized program compared outcome results to clients from publicly funded MM programs in Orange, Riverside and San Bernardino counties (129 men, 131 women). In a secondary analysis, San Diego clients who transferred into private (fee-for-service) treatment programs were compared with those who did not transfer. Major adverse consequences were found for clients unable or unwilling to transfer to private programs: higher crime and dealing rates, more contact with the criminal justice system, and higher rates of illicit drug use were demonstrated by nontransfer clients. Moreover, the savings resulting from a reduction of MM program costs were nearly offset by increased direct costs for incarceration, legal supervision, and other government- funded drug treatment. Indirect costs were not assessed.