Outcomes for Physicians With Opioid Dependence Treated Without Agonist Pharmacotherapy in Physician Health Programs
Outcomes for Physicians With Opioid Dependence Treated Without Agonist Pharmacotherapy in Physician Health Programs
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DOI：
10.1016/j.jsat.2016.02.004
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发表时间：
2016-05-01
影响因子：
3.9
通讯作者：
DuPont, Robert L.
中科院分区：
文献类型：
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作者：
Merlo, Lisa J.;Campbell, Michael D.;DuPont, Robert L.
目标：比较参加医生健康计划（PHP）的物质依赖医生的治疗结果，这些医生仅具有酒精使用史、任何阿片类药物使用史或非阿片类药物使用史，以确定独特的PHP护理管理系统对阿片类药物使用障碍患者是否与酒精或其他药物使用障碍患者一样有效。方法：对16个医生健康项目的所有医生（N = 702; 85.5%男性;年龄范围= 24-75）进行了5年回顾性病历审查和意向治疗分析。分析根据参与者滥用的物质[即，1)“仅酒精”（n = 204），2）“任何阿片类药物”与或不与酒精的使用（n = 339），和3）“非阿片类药物”与或不与酒精的使用（n = 159）]。结果：在这个样本中，75-80%的医生在他们的延长护理管理期间与随机药物测试从未测试酒精或药物呈阳性。这包括没有接受阿片类药物替代疗法（OST）的阿片类药物依赖医生。在22.1%的医生谁有一个积极的测试，三分之二（即，总样本的14.5%）只有一个阳性测试，只有三分之一（即，占总样本的7.6%）有一个以上的阳性检测。这些结果是相似的，在所有三个groups.Conclusions：这些结果表明，个人与阿片类药物使用障碍谁是管理PHPs可以实现长期禁欲阿片类药物，酒精，和其他药物没有OST通过参与基于禁欲的心理社会治疗与扩展，重症监护管理出院后。(C)2016 Elsevier Inc. All rights reserved.
Aims: To compare treatment outcome among substance dependent physicians enrolled in a physician health program (PHP) who have a history of alcohol use only, any opioid use, or non-opioid drug use, in order to determine whether the distinctive PHP system of care management is as effective for individuals with opioid use disorders as for those with alcohol or other drug use disorders.Methods: A 5-year, retrospective chart review, intent-to-treat analysis was conducted for all physicians admitted to 16 physician health programs (N = 702; 85.5% male; age range = 24-75). Analyses compared treatment outcomes for participants based upon their substance(s) of abuse [i.e., 1) "Alcohol Only" (n = 204), 2) "Any Opioid" with or without alcohol use (n = 339), and 3) "Non-Opioid" drug use with or without alcohol use (n = 159)].Results: In this sample, 75-80% of physicians across the three groups never tested positive for alcohol or drugs during their extended care management period with random drug testing. This included physicians with opioid dependence who did not receive opioid substitution therapy (OST). Of the 22.1% of physicians who had a positive test, two thirds (i.e., 14.5% of the total sample) had just one positive test, and only one third (i.e., 7.6% of the total sample) had more than one positive test. These results were similar in all three groups.Conclusions: These results indicate that individuals with opioid use disorders who are managed by PHPs can achieve long-term abstinence from opioids, alcohol, and other drugs without OST through participation in abstinence-based psychosocial treatment with extended, intensive care management following discharge. (C) 2016 Elsevier Inc. All rights reserved.