某綜合醫院美沙冬替代療法個案之臨床特徵

Clinical Characteristics of Heroin Injection Drug Users in Methadone Maintenance Treatment Clinic in a General Hospital

目的：本研究係為分析某綜合醫院參加美沙冬替代療法的441名海洛因成癮者之特性。方法：本研究總共收集441名符合鴉片類依賴，且參加美沙冬替代療法的病人。記錄其人口學資料，及B型肝炎病毒、C型肝炎病毒、愛滋病毒的檢驗結果。結果：第一次使用海洛因的年齡，以20-29歲為最多，參加替代療法時的年齡，則以30-39歲為最多，平均使用海洛因的時間為9.45±5.77年。傳染病學方面，感染C型肝炎病毒者佔91.8%，感染B型肝炎病毒者佔12.7%，感染愛滋病毒者佔12.9%。治療後，購買海洛因的花費及注射頻率，皆有下降，且降幅達統計學上的意義(p<0.001)。初次注射海洛因的年齡，和治療前物質使用的時間呈現負相關，但是開始接受美沙冬替代療法時的年齡、治療前海洛因注射的頻率、及入獄次數，則和治療前物質使用的時間呈現正相關。結論：美沙冬替代療法可降低海洛因注射的頻率及花費。為了減少治療前物質使用的時間，應該特別針對年輕、重度的物質使用者、及多次入獄者，施行此一療法。

Purposes: This study characterized 441 heroin addicts in methadone maintenance treatment (MMT) in a general hospital. Methods: A total of 441 patients who met a diagnosis of opioid dependence and accessed the MMT program were recruited for this study. Demographic data were recorded and laboratory analysis for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections were performed. Results: Age at initial heroin use ranged 20-29 years, age beginning MMT ranged 30-39 years, and mean years of drug use was 9.45±5.77. Infections included HCV (91.8%), HBV (12.7%) and HIV (12.9%). Heroin cost per day and frequency of heroin injections decreased significantly (p＜0.001) after MMT. Age at first heroin injection negatively correlated with duration of drug use before MMT, but age at beginning MMT, frequency of heroin injections before MMT and number of incarcerations positively correlated with duration of drug use before MMT. Conclusions: MMT reduced cost and frequency of heroin injection. To reduce the duration of drug use before MMT, the program should target young drug users, heavily drug users and the prisoner with high number of incarcerations.