Outpatient treatment engagement and abstinence rates following inpatient opioid detoxification
Outpatient treatment engagement and abstinence rates following inpatient opioid detoxification
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DOI：
10.1300/j069v25n04_03
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发表时间：
2006-01-01
影响因子：
2.3
通讯作者：
Kivlahan, Daniel R.
中科院分区：
文献类型：
--
作者：
Davison, John W.;Sweeney, Marie L.;Kivlahan, Daniel R.
许多慢性阿片类药物依赖的患者在住院戒毒后被转介到无药物门诊治疗，即使成功的门诊治疗参与和戒断阿片类药物只发生在少数病例中。这项对医疗记录的回顾性队列分析记录了出院后的治疗结果，该治疗环境最大限度地支持过渡到以戒断为导向的门诊治疗，提供全面的社会、医疗和心理健康服务，包括纳曲酮的可用性。参与者是在城市退伍军人医疗中心入院的男性退伍军人（N = 112）。大多数患者（78%）成功完成了急性解毒，49%开始使用纳曲酮，76%接受了VA术后护理计划。在90天的随访中，只有22%的人留在了术后护理中，不到3%的人有毒理学证实的阿片类药物戒断。在一年的随访中，五分之一的人再次接受戒毒治疗，4.5%的人死亡。大多数患者成功地从阿片类药物中解毒，但很少有人继续从事并稳定在禁欲导向的门诊治疗中。
Many patients with chronic opioid dependence are referred to drug-free outpatient treatment following inpatient detoxification even though successful outpatient treatment engagement and abstinence from opioids occur only in a minority of cases. This retrospective cohort analysis of medical records documents the post-discharge outcome in a treatment setting that maximizes the support during transition to abstinence-oriented outpatient care, with comprehensive social, medical and mental health services, including the availability of naltrexone. Participants were male veterans (N = 112) admitted at an urban VA medical center. Most patients (78%) successfully completed acute detoxification, 49% initiated naltrexone, and 76% accepted a VA aftercare plan. At 90-day follow-up, only 22% remained in aftercare, and < 3% had toxicology-verified abstinence from opioids. At one-year follow-up, 1 out of 5 had been readmitted for detoxification and 4.5% had died. Most patients successfully detoxified from opioids, but very few remained engaged and stabilized in abstinence-oriented outpatient treatment.