出院藥癮病人的追蹤

The Follow-up of Discharged Drug-Addicted Patients

近年來吸毒人口激增，引起社會大眾之關注，戒毒機構的林立似乎未能減少吸毒人數，本研究的目的在探討藥物成癮者戒治後再度使用的相關因素，期以做為參與藥癮戒治者的參考。本研究以前瞻性追蹤研究方式，以高雄市立凱旋醫院煙毒勒戒科完成凱旋戒治模式的個案為對象，其中安非他命組67位，鴉片類組81位，皆完成持續一年的追蹤，並以治療前、中、後三因素來分析，結果如下：(1)治療前因素：濫用藥物時間愈短者，預後愈好。(2)增加治療內容及治療時間的凱旋戒治模式，可提高戒治的成效。(3)治療後因素：「自我因應」缺失（如失眠、情緒低落、失去興趣、緊張、發脾氣等）及「人際互動」缺失（如無固定工作，與以前吸毒朋友來往等）是影響再度使用最主要的因素。根據本研究的結果，為提高戒治成效，提供以下四點建議：(1)早期發現，早期治療。(2)藥癮戒治在治療設計上或法律上的管理，至少需要六個月。(3)藥癮戒治的過程中，須積極輔以「認知行為技巧訓練」，以幫助個案學習因應面對藥物的誘惑時，能避免再度使用。(4)鼓勵企業家提供戒治後的藥癮患者工作機會，使他們能在非毒環境下工作，並從工作中重建信心，遠離毒品。

148 drug addicts comprising 67 amphetamine and 81 opiate cases were followed up one year after discharge from Narcotics Abstinence Department in Kai-Suan Psychiatric Hospital and Institute. The factors associated with lapse or relapse were studied. Results showed that shorter duration of substance abuse (less than one year) was related to the least postreatment drug use. The provision of special services and length of time in treatment were more related to abstinence success. A varity of intrapersonal deficits (insomnia, depressive mood, nervousness, loss of interest, bad temper etc.) and interpersonal deficits (unemployment, reinforcement by drug-using friends) were the major lapse or relapse factors. It is suggested that early finding and treatment help in better outcome, the provision of special services during treatment including cognitive-behavioral skill training might help in the reduction of lapse or relapse rate, and a minimum of six-month duration is suggested for either abstinence treatment or law enforcement.