Methadone diversion as a protective strategy: the harm reduction potential of 'generous constraints'.
Methadone diversion as a protective strategy: the harm reduction potential of 'generous constraints'.
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DOI：
10.1016/j.drugpo.2012.10.003
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发表时间：
2013-11-01
期刊：
影响因子：
--
通讯作者：
Rhodes, Tim
中科院分区：
文献类型：
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作者：
Harris, Magdalena;Rhodes, Tim
美沙酮维持治疗在预防血液传播病毒和其他注射相关危害方面被证明是一项成功的减少危害举措。这是由于海洛因使用和共用注射器具事件减少，但实现这些目标的手段很少得到阐述。美沙酮转移主要是在负面的光;与过量和其他危害。在我们对37名注射毒品的人进行的定性研究中，35名接受替代疗法，我们发现美沙酮自我调节和转移在帮助参与者管理他们的药物使用，防止戒断，巩固社会关系以及无意中防止丙型肝炎传播方面发挥了突出作用。参与者制定这些“本土减少伤害策略”的能力在不同程度上受到其治疗剂量方案的限制。在这篇文章中，我们探讨的战略参与者制定美沙酮，“慷慨的限制”在此制定和相关的生产和减少风险的作用。为了让注射毒品者重新参与减少危害的干预措施，有必要采取措施，评估个人已经在使用的本地战略，并在美沙酮自我调节的情况下，通过实施更慷慨的限制来支持他们。
Methadone maintenance treatment is evidenced as a successful harm reduction initiative in regard to the prevention of blood borne viruses and other injecting related harms. This is attributable to reductions in heroin use and injecting equipment sharing incidents, yet the means by which these are achieved are rarely elaborated. Methadone diversion is predominantly presented in a negative light; associated with overdose and other harms. In our qualitative London-based study with 37 people who inject drugs, 35 on substitution therapies, we found that methadone self regulation and diversion played a prominent role in helping participants to manage their drug use, prevent withdrawal, cement social relationships, and inadvertently protect against hepatitis C transmission. The ability of participants to enact these 'indigenous harm reduction strategies' was constrained to various degrees by their treatment dosing protocols. In this article we explore the strategies participants enacted with methadone, the role of 'generous constraints' in this enactment and the associated production and reduction of risk. In order to reengage people who inject drugs with harm reduction interventions, it is necessary for initiatives to take stock of the indigenous strategies that individuals are already utilising and - in the case of methadone self regulation - support them by the implementation of more generous constraints.