FORTNIGHTLY REVIEW - METHADONE-MAINTENANCE TREATMENT IN OPIATE DEPENDENCE - A REVIEW
FORTNIGHTLY REVIEW - METHADONE-MAINTENANCE TREATMENT IN OPIATE DEPENDENCE - A REVIEW
复制标题
DOI：
10.1136/bmj.309.6960.997
复制
发表时间：
1994-10-15
影响因子：
105.7
通讯作者：
STRANG, J
中科院分区：
文献类型：
--
作者：
FARRELL, M;WARD, J;STRANG, J
本文探讨了研究和临床实践的变化和进展，并探讨了美沙酮维持治疗的结构和方案特点的作用。在过去十年，美沙酮处方已变得更容易获得，无论是在有使用美沙酮历史的国家，如英国和澳大利亚，还是在世界各地以前没有认可替代处方的国家。1有必要仔细审查提供这种治疗的框架，以确保使用从成本和效益角度来看最有效的提供模式。本次审查完全集中在美沙酮维持治疗，因为这是最广泛评估和最常用的治疗，全球约有25万药物滥用者接受美沙酮治疗。一些国家正在对少数试验性二乙酰吗啡和丁丙诺啡替代方案进行评价，大多数研究来自美国，侧重于在特定环境中长期使用美沙酮的情况;相比之下，联合王国的美沙酮治疗迄今为止除一项研究外几乎没有得到任何正式评价。2.有人担心，大量美沙酮处方对非法药物使用或冒险行为的影响可能很小，3最近对警方拘留的吸毒者进行的研究也反映了这一点。4滥用药物问题咨询理事会建议改用更有条理的方法提供口服美沙酮维持治疗。
This paper examines the changes and advances in research and clinical practice and examines the role of treatment structure and programme characteristics in the delivery of methadone maintenance. Methadone prescribing has become much more available over the past decade, both in countries with a history of its use, such as the United Kingdom and Australia, and in countries around the world which previously had not endorsed substitute prescribing. 1 There is a need to examine closely the framework in which this treatment is delivered to ensure that the modes of delivery most effective from both cost and benefit perspectives are utilised. This review focuses entirely on methadone maintenance because this is the most extensively evaluated and most used treatment, with about a quarter of a million drug misusers receiving methadone treatment globally. A small number of experimental diamorphine and buprenorphine substitute programmes are being evaluated in several countries.Most studies have come from the United States and focus on the long term use of methadone in a specific setting; in contrast, methadone treatment in the United Kingdom has received virtually no formal evaluation to date bar one study. 2 There is concern that a considerable amount of the methadone prescribing could be having little impact on illicit drug use or risk taking behaviour, 3 a recent study of drug users in police custody echoes this. 4 The Advisory Council on the Misuse of Drugs has recommended a shift to a more structured approach for delivery of oral methadone maintenance.