臺灣地方毒品危害防制中心成立後戒癮更生人的再犯率

Recidivism Rates of Released Drug Offenders after the Local Drug Abuse Prevention Center Implemented in Taiwan

背景：自2006 年6 月，國內反毒政策由中央落實到地方政府。地方毒品危害防制中心（以下簡稱「毒危中心」）成立後成效如何，特別是更生人的再犯率是否有下降，非常值得關注。目的：整理桃園毒危中心2006 年10 月至2008 年2 月的通報個案，與警方查獲持有或使用成癮藥品者的紀錄，或與法務部入獄服刑資料作連結，計算再犯率，以評估其輔導成效。材料與方法：本研究分兩部份進行，普查及抽樣。普查為桃園毒危中心2006年10 月至2008 年2 月所有通報個案，與桃園警方查獲持有或使用成癮藥品者的紀錄（到2008 年9 月）作連結，計算再犯率。抽樣為桃園毒危中心2006 年10 月至2008 年2 月所有通報個案，有聯繫上的個案（含本人或家屬），進行分層等距抽樣。與桃園警方查獲持有或使用成癮藥品者的紀錄（至2009 年12 月）及法務部入獄服刑資料（2011 年5 月）作連結，計算再犯率。結果：普查方面，採1745 人資料作統計分析。有聯繫上（含本人或家屬）的有1176 人（67.4%）、沒有聯繫上的有569 人（32.6%）。因持有或使用成癮藥品被警方逮捕共367 人，即2 年內再犯率為21.0%，95%CI 在19.9%-22.9%。有聯繫上的更生人，因持有或使用成癮藥品被警方逮捕共有252 人（21.4%）。沒有聯繫上的更生人，因持有或使用成癮藥品被警方逮捕共有115 人（20.2%）。兩組再犯率沒有統計顯著差異。有聯繫上（含本人或家屬）的個案1176 人，抽樣得612 人次。在有聯繫上的個案中，未聯繫到本人有272 位（44.4%），有聯繫到本人有340 位（55.6%）。其中聯繫到本人1 次有131 位（21.4%）、連繫到本人2 次有79 位（12.9%）、聯繫到本人3 次以上有130 位（21.2%）。整體而言3.2 年內的再犯率為50.0%，95%CI 在46.0%-54.0%。追蹤輔導未聯繫到本人的再犯率（58.5%）最高，其次為聯繫到本人1、2 次（54.2%、50.6%），追蹤輔導聯繫到本人3 次以上的再犯率最低（27.7%）。隨著追蹤輔導聯繫到本人的次數增加，再犯率有下降的趨勢，達統計顯著意義（p <.0001）。有藥癮問題者的再犯率較高（58.0%）。男性的再犯率（52.1%）明顯高於女性（39.0%）。Cox’s proportional hazards model 結果顯示，追蹤輔導沒有聯繫到本人、只聯繫到本人1 次、2 次的再犯風險為有聯繫到本人3 次以上的3.8 倍、2.8倍、2.4 倍。有藥癮問題者的再犯風險為沒有藥癮問題的1.5 倍。男性的再犯風險為女性的1.5 倍。結論： 戒癮更生人出監後， 桃園毒危中心能聯繫上本人或家屬之比例為67.4%，聯繫上本人只有37.5%，而2 年的整體再犯率（持有或使用成癮藥品被桃園地區警方逮捕）為21.0%。針對能聯繫上本人或家屬之戒癮更生人，其3.2 年內的再犯率（持有或使用成癮藥品被桃園地區警方逮捕，或入獄服刑）為50.0%，毒危中心追蹤輔導本人次數愈多其再犯率有降低趨勢。建議地方毒危中心持續對戒癮更生人提供追蹤輔導關懷。

Background: The drug abuse prevention policy in Taiwan has been implemented by the central government at the local government level since June 2006. However, whether recidivism rates are reduced is unknown. Aims: To estimate the recidivism rate by linking the list of released drug offenders from Taoyuan Drug Abuse Prevention Center (DAPC) with arrest records in Taoyuan and nationwide prisoner in-out records. Materials and method: (1) Census: All released drug offenders reported to Taoyuan DAPC from October 2006 to February 2008. The recidivism rate was based on the Taoyuan police arrest records up to Sept., 2008. (2) Sampling: A stratified systematic sample was made for released drug offenders who were able to contact (released drug offenders him/her-self or his/her family members) by Taoyuan DAPC to find out the amount of counseling service received. Recidivism was based on the police arrest records in Taoyuan (up to December, 2009) and nationwide prisoner in-out records (up to May, 2011).Results: (1) Census: There were 1745 released drug offenders reported to Taoyuan DAPC . 1,176 (67.4%) were able to contact (including released drug offenders or family members). The overall 2-year recidivism rate was 21.0% (95%CI=19.1%-22.9%). There was no statistically significant difference in the recidivism rate between those who were contacted and those who were not contacted by Taoyuan DAPC. (2) Sampling: Among the 1176 drug offenders of whom we were able to contact the offender him/herself or a family member, 612 were sampled. A total of 272 (44.4%) drug offenders were contacted directly. 131 (21.4%) were contacted once, 79 (12.9%) twice, and 130 (21.2%) three or more times. The overall 3.2 year recidivism rate was 50.0%, with a 95% CI between 46.0% and 54.0%. The recidivism rate was the highest for those who we failed contact (58.5%), followed by those who were contacted once or twice (54.2%, 50.6%), and was the lowest among those who were contacted three or more times (27.7%) (p<.0001). The recidivism rate was higher for those who self-reported having a drug problem (58.0%), in comparison to those who did not (48.2%). Males had a higher recidivism rate(52.1%) than did females (39.0%). Cox’s proportional hazards model reveals that number of times contacted, gender, and self-report having a drug problem were significantly associated with recidivism rate. The hazard ratios of recidivism for those who we fail contact directly, for those who were contacted once and those were contacted twice, were 3.8, 2.8 and 2.4, respectively, when compared with those who were contact three or more times. The hazard ratio of recidivism was 1.5 for those who self-reported having a drug problem when compared with those who did not. The hazard ratio of recidivism was 1.5 for male offenders when compared with female offenders. Conclusions: The DAPC was able to contact 67.4% of released drug offenders (the offender him/her-self or a family member). However, we were only able to contact 37% of the offenders directly. The 2-year recidivism rate (based on Taoyuan police arrested records) was 21%. The 3.2-year recidivism rate (based on Taoyuan police arrest records and nationwide prisoner in-out records) was 50% for those who we were able to contact the offender him/her-self or a family member. The recidivism rate decreased with the frequency of direct contact with the offenders. We suggest that the DAPC should continue counseling released drug offenders.