Time to relapse following treatment for methamphetamine use: a long-term perspective on patterns and predictors.
Time to relapse following treatment for methamphetamine use: a long-term perspective on patterns and predictors.
复制标题
在使用甲基苯丙胺治疗后复发的时间：对模式和预测因子的长期观点。
DOI：
10.1016/j.drugalcdep.2014.02.702
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发表时间：
2014-06-01
影响因子：
4.2
通讯作者：
Herbeck D
中科院分区：
文献类型：
--
作者：
Brecht ML;Herbeck D
本文介绍了甲基苯丙胺（MA）的使用模式，特别是持续禁欲的持续时间（“复发时间”），平均5年后，从MA使用治疗出院，并与选定的用户和治疗特征的关系。从一个大的县物质使用障碍（SUD）治疗系统的350个治疗入院的样本是随机选择的（在性别，种族/民族，治疗方式分层）。回顾性自我报告数据来自治疗后约3年进行的自然病史访谈（NHI）和2-3年后的随访。复发定义为任何使用MA的情况，时间为治疗出院后持续MA戒断的月数，直至复发。该结果是根据使用NHI数据的每月MA使用时间轴构建的。使用考克斯模型检查复发时间和预测因子。61%的样本在治疗出院后1年内复发至MA使用，25%在第2-5年期间复发。预测复发时间较长的重要保护因素包括经历过严重的MA相关精神/行为问题（风险比[HR]=0.75，p=0.027），索引治疗发作持续时间较长（HR=0.93，p=0.001），并在治疗后戒断期间参与自助或其他治疗（HR=0.29，p<0.001）;复发时间较短的风险因素包括父母有酗酒和/或吸毒问题（HR =1.35，p=0.020）和参与MA销售（HR=1.48，p=0.002）。结果有助于对治疗后MA使用模式的长期观点，并支持早期治疗后和长期持续护理和复发预防服务的需求。
This paper describes methamphetamine (MA) use patterns, specifically duration of continuing abstinence (“time to relapse”) for periods averaging 5 years post-discharge from treatment for MA use, and the relationship with selected user and treatment characteristics. A sample of 350 treatment admissions from a large county substance use disorder (SUD) treatment system was randomly selected (within gender, race/ethnicity, treatment modality strata). Retrospective self-report data are from natural history interviews (NHI) conducted approximately 3 years after treatment and a follow-up 2-3 years later. Relapse is defined as any use of MA with time as the number of months of continuous MA abstinence after treatment discharge until relapse. This outcome was constructed from a monthly MA use timeline using NHI data. A Cox model was used to examine time to relapse and predictors. Sixty-one percent of the sample relapsed to MA use within 1 year after treatment discharge and 25% during years 2-5. Significant protective factors predicting longer time to relapse included having experienced serious MA-related psychiatric/behavioral problems (hazard ratio [HR]=0.75, p=0.027), longer duration of the index treatment episode (HR=0.93, p=0.001), and participating in self-help or other treatment during the post-treatment abstinence period(HR=0.29, p<0.001); risk factors for shorter time to relapse included having a parent with alcohol and/or drug use problems (HR =1.35, p=0.020) and involvement in MA sales (HR=1.48, p=0.002). Results contribute a long-term perspective on patterns of MA use following treatment and support a need for early post-treatment and long-term continuing care and relapse- prevention services.