社区综合干预海洛因依赖者的无缝连接模式研究

摘要

目的 评估通过在戒毒机构和社区层面间建立有效的“无缝连接”对我国社区康复海洛因依赖者的作用.方法 采用成瘾行为严重程度指数量表(ASI)、症状自评量表(SCL-90)等对进行了2年社会心理综合干预的210例社区康复海洛因依赖者进行社会、心理功能分析,并筛检尿液阳性率.结果 2年随访时,社区康复海洛因依赖者的躯体健康、酒精使用、职业功能、违法犯罪、家庭关系、精神健康较基线降低(P＜0.01)；就业率较基线提高(50.8％∶22.4％),犯罪率(1.6％∶6.2％)和尿检阳性率(34.6％∶61.4％)较基线降低(x2=34.57,7.84,32.23；P均＜0.01)；SCL-90的10个维度较基线明显降低(P＜0.01).结论 基于“无缝连接”机制的社会心理综合干预方法降低了社区康复人员的复吸及毒品相关问题,提高了社会心理功能,改善了个体的健康状况.%Objective To evaluate the effects of community-based psychosocial integrated approach on psychosocial rehabilitation and relapse prevention of heroin addicts in community,to set up "seamless connection" mechanisms between the drug treatment facilities and communities and to explore a comprehensive rehabilitation model that is adaptive to Chinese culture.Methods 210 heroin addicts in community received a 24-month psychosocial integrated intervention.Their abstinence rates and psychosocial functions were assessed using the Addiction Severity Index (ASI) and Self-reporting Inventory (SCL-90)before and after intervention,respectively.Results The psychosocial integrated intervention significantly improved heroin addicts' physical health,occupational functioning,family relationships and mental health,and to reduce alcohol use,criminal activity (P ＜ 0.01),significantly improved the employment rates (50.8％ vs.22.4％),and to reduce criminal activity rates(1.6％ vs.6.2％) and the proportion of positive urine tests (34.6％ vs.61.4％) (P ＜ 0.01),significantly improved the ten dimensions of psychological symptoms (P ＜ 0.01).Conclusions The integrated treatment using ‘ seamless connection' mechanism reduces relapse and drug use related problems and increases the wellbeing in the individuals with drug dependence recovering in the community.