機構戒癮處遇的回顧與前瞻

Retrospect and Prospect of Institutional Addiction Treatment

本文分析我國近30年以來之反毒政策及趨勢，及對機構戒癮處遇之發展脈絡、新增人數及處遇內涵進行探討，並依機構戒癮處遇之現況提出研究建議。從我國數次專案調整之反毒政策及研修之毒品危害防制條例，於戒毒工作之目標或策略可知，早期係以健全法令及藥癮戒治體系為主，之後逐漸擴大結合民間戒毒資源，更重視社區導向之支持與戒癮作為，並致力於戒治資源整合及強化復歸社會之成效等，整體戒癮政策從強調對毒品施用者之懲罰轉向為以治療為主，刑罰為輔；治療對象從個人擴大至與社區之整合；治療資源從醫療機構到公私部門跨域合作；治療專業亦從藥物治療到納入整合社會工作及心理治療等各種專業。綜上，我國對於毒品施用者係採「自願優先於強制」、「社區優先於機構」及「治療優先於處罰」之3項戒癮原則。本研究分析受觀察勒戒人、受戒治人、受刑人及緩起訴處分於2008年至2019年間各年新增人數發現，以2019年和2008年之人數比較，受觀察勒戒人減少63.24％，受戒治人減少88.31％，受刑人減少37.91％。緩起訴處分人數則增加逾3.5倍，顯見我國近12年來之機構處遇戒癮人數大幅降低，而社區戒癮人數則大幅增加，戒癮處遇發展方向與歷來反毒政策之變化相當一致。我國提供戒癮處遇之機構主要包括醫療機構、民間戒癮輔導機構及矯正機關，而其中矯正機關為健全毒品犯處遇，共同推動「科學實證之毒品犯處遇模式計畫」，逐漸提昇處遇之專業性。研究者就機構戒癮處遇現況及參考反毒政策中戒毒處遇之策略，建議未來可再重視或推動：擴大醫療優先措施、個人戒癮導向轉向至社區整合、以容許復發取代再犯零容忍、整合矯正機關輔導人力等4項措施，以持續精進機構戒癮處遇成效。

This article analyzes the anti-drug policies and trends in the past 30 consecutive years, as well as the development context of institutional drug treatment, the new number of people and the connotation of the situation, and proposes research recommendations based on the current situation of institutional drug treatment. From the anti-drug policy adjusted by several projects and the regulations on the prevention and control of drug harm in our country, the goal or strategy of drug rehabilitation work can be seen. The early stage was to improve the laws and drug addiction treatment system, and then gradually expand the integration of private drug rehabilitation resources. Pay more attention to community-oriented support and addiction treatment, and devote to the integration of treatment resources and strengthening the effectiveness of reintegration into society. The overall addiction treatment policy has shifted from emphasizing the punishment of drug users to focusing on treatment, supplemented by punishment; Targets expand from individuals to integration with the community; treatment resources range from medical institutions to public-private sector cooperation; the treatment profession also ranges from drug treatment to integration of social work and psychotherapy. In summary, my country adopts the three principles of ＂voluntary priority over compulsory＂, ＂community priority over institution＂ and ＂treatment priority over punishment＂ for drug users. This study analyzes the number of newly-increased persons subject to observing extortion, extermination, inmates, and deferred prosecution from 2008 to 2019 and found that comparing the number of people in 2019 and 2008, the number of observing extortionists decreased by 63.24% , The number of people under precept and treatment decreased by 88.31%, and the number of prisoners decreased by 37.91%. The number of deferred prosecution sanctions has increased by more than 3.5 times. It is obvious that the number of people who have been withdrawn from addiction in institutions in my country has dropped significantly in the past 12 years, while the number of people who have been withdrawn from community addiction has increased significantly. The development direction of addiction treatment is quite consistent with the historical changes in anti-drug policies The institutions that provide addiction treatment in my country mainly include medical institutions, private addiction counseling institutions, and correctional institutions. Among them, the correctional institution is to improve the treatment of drug offenders, and jointly promote the ＂Scientific and Evidenced Drug Offender Treatment Model Project＂, which is gradually increasing The professionalism of the treatment. Based on the current situation of drug treatment in institutions and referring to the strategies of drug treatment in the anti-drug policy, the researchers suggest that further emphasis or promotion can be given in the future: expansion of medical priority measures, personal withdrawal of addiction to community integration, and zero tolerance for relapse instead of recidivism , Integrate 4 measures including the counseling manpower of correction agencies, and continue to improve the agency's addiction treatment to achieve results.