甲基安非他命藥癮者治療預後因子分析－－緩起訴二級毒品附命戒癮治療相關因素及性別差異分析研究

A Gender Difference Analysis of Factors Correlated with Treatment Outcomes for Methamphetamine Use Patients in a Deferred Prosecution Program for Drug Offenders

研究目的：為探討影響甲基安非他命藥癮者完成治療之相關因素，並進行性別差異分析。研究方法：以2016-2018年北部某醫院二級毒品緩起訴附命戒癮治療藥癮者為研究對象，分為中斷治療及完成治療組。分析人口學、物質使用、精神及生理共病、尿液檢驗、衝動控制及改變階段，比較兩組和性別分組間之差異性，找出影響治療完成相關因子。研究結果：共納入916位甲基安非他命藥癮者，完成治療比例為76.3%。與未完成組相比，完成組年齡在35歲以上（p < 0.05）、有伴侶（p < 0.05）、有就業（p < 0.05）的比例較高，衝動性較低（p < 0.05）。完成組第一次驗尿陽性率（p < 0.001）及同儕使用海洛因比率（p < 0.05）較低。性別差異部分，影響女性藥癮者治療因子為年齡及衝動控制程度；男性藥癮者為伴侶狀態、飲酒史及衝動控制程度。研究結論：甲基安非他命使用者的年齡、伴侶狀態、就業、衝動控制、是否有使用毒品同儕、及第一次驗尿結果等因素與是否完成緩起訴治療相關。影響男女性藥癮者之因素略有不同。研究結果可作為未來設計藥癮治療方案之參考。

Purpose: Methamphetamine abuse is a world-wide problem that lacks promising interventions. We designed this study to identify the factors associated with treatment outcomes for methamphetamine abuse patients participating in a deferred prosecution treatment program for drug offenders in Taiwan. Methods: We conducted a retrospective case-control study at a psychiatric center in northern Taiwan. We recruited 916 methamphetamine abuse patients by reviewing their medical charts. We examined whether any of the following factors related to treatment completion: demographic data, self-report substance use records, physical and psychiatric comorbidities, lab data, and behavioral measures (impulsivity and stage of readiness of change). Chi-square tests and logistic regression were applied to test for differences between the completion and drop-out groups, and for gender analysis. Results: The treatment completion rate was 76.3%. Compared with the drop-out group, the completion group was significantly older, and more likely to be married or in a relationship, to have a job, and to be less impulsive. The completion group also had a significantly lower positivity rate on their first urine test and a lower percentage of peer heroin use. Treatment completion by female methamphetamine users was significantly positively correlated with age and significantly negatively correlated with impulsivity; for male users, treatment completion correlated significantly positively with relationship status, and significantly negatively with drinking history and impulsivity level. Conclusion: Gender and impulsivity influence the treatment completion rate of methamphetamine users. The results provide information to tailor intervention programs for methamphetamine abuse patients.