台灣地區毒癮者接受美沙酮替代療法後再犯毒品之 成因探討

The Factors Cause Recidivism of Addicts after taking Methadone Maintenance Treatment in Taiwan

目標：台灣地區自2005年8月引進美沙酮替代療法（MethadoneMaintenanceTreatment,MMT），目前是我國防制一級毒品之重要策略。但在引進替代療法後，截至2010年底毒品再犯率並未有明顯改善。原因究竟是替代療法療效不佳？或配套措施沒有做好？本研究乃對曾接受替代療法療卻又再犯毒品案而入監服刑之毒品犯進行實證研究，以作為我國毒品政策檢討之參考。方法：本研究採非實驗設計研究方法，以2009年上半年出監的一級毒品毒癮者曾接受替代療法（664人）而又再犯毒品案件入監64人為研究對象。以問卷調查進行計量分析為主，文獻探討為輔。結果：研究發現97.06%接受替代療法而再犯毒品之藥癮者認為替代療法非常有幫助或有些幫助。接受替代療法前每週平均使用海洛因次數為20.80次，使用替代療法期間每週平均使用海洛因次數為3.41次，顯示效果明顯。而受訪者既認為有效，何以再犯之原因調查，發現影響其使用替代療法之主要因素首為取用藥物不便，次為擔心美沙酮亦會成癮，三為毒友勸誘。結論：替代療法經實際調查證實具有降低再犯毒品效果，但與電腦統計之實際高再犯率有明顯差距，替代療法之配套施行措施應再探討。關鍵詞：美沙酮替代療法、減害、毒品危害防制中心、再犯率、資料探勘

Objectives: Methadone Maintenance Treatment (MMT) was proved as an effective approach to reduce the harm of opioid drug abuse in EU, Austria, etc. Taiwan government introduced MMT in2005, now is one of the major strategies for fighting with drug abuse issues. This research aim to evaluate if MMT performed adequately in Taiwan, what are major drawbacks cause addicts recommit criminal cases of drug abuse. Methods: Quantitative approach via interview and questionnaires were applied in this research. Total 68 out of 664 addicts that adopted MMT but recommitted drug cases were surveyed. Results: 97.06% of surveyed addicts regard that MMT is very helpful or provide some help. The average frequency of Heroin recommit of is 20.80 per week before MMT, The average fre-quency of Heroin recommit of is 3.41 per week after adopted MMT. There exists distance of MMT efficacy between the real recidivism and the recognition of addicts. Conclusions: the adequacy of MMT implementation and supporting measures in Taiwan still needed to be examined.