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首页> 外文期刊>Journal of studies on alcohol >Opioid substitution treatment reduces substance use equivalently in patients with and without posttraumatic stress disorder.
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Opioid substitution treatment reduces substance use equivalently in patients with and without posttraumatic stress disorder.

机译：阿片类药物替代治疗可在有或没有创伤后应激障碍的患者中等效减少药物的使用。

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OBJECTIVE: The purpose of this study was to determine whether opioid-dependent patients with diagnosed posttraumatic stress disorder (PTSD) have poorer long-term outcomes in opioid substitution treatment than do patients without PTSD. METHOD: This prospective observational study examined outcomes of 255 opioid-dependent patients (men = 248) entering opioid substitution treatment at eight clinics in the Veterans Health Administration (VHA). Subjects were interviewed at treatment entry, 6 months, and 1 year about substance use and related problems, health status, treatment satisfaction, and non-VHA health care utilization. Medical records were reviewed to obtain toxicology results, health care utilization data, and diagnoses. Medical record review identified a diagnosis of PTSD in 71 (28%) patients. Substance-use and mental-health outcomes and health care utilization in the first year following treatment entry were compared between patients with and without a diagnosis of PTSD. RESULTS: Patients with andwithout PTSD had similar treatment responses. Although patients with PTSD had longer histories of drug use at intake, at 1-year follow-up they showed reductions in heroin, cocaine, and alcohol use, comparable to patients without the disorder. PTSD patients received higher doses of opiate medication, attended more psychosocial treatment sessions for substance-use disorder, and had better treatment retention. Psychiatric symptoms for patients with PTSD were more severe at intake and showed little improvement throughout treatment. CONCLUSIONS: Opioid substitution therapy is as effective at reducing substance use in PTSD patients as it is in patients without the disorder, but additional services are needed for treatment of psychological problems that are largely unchanged by treatment for addiction.
机译：目的：本研究的目的是确定诊断为创伤后应激障碍（PTSD）的阿片类药物依赖患者与没有PTSD的患者相比，在阿片类药物替代治疗中的长期结局是否较差。方法：这项前瞻性观察性研究在退伍军人卫生管理局（VHA）的八家诊所检查了255名接受阿片类药物替代治疗的患者（男性= 248名）的结局。在进入治疗，6个月和1年的时间里对受试者进行了有关药物使用和相关问题，健康状况，治疗满意度以及非VHA卫生保健利用率的访谈。审查病历以获得毒理学结果，卫生保健利用数据和诊断。病历审查确定了71名（28％）患者的PTSD诊断。比较进入和未诊断为PTSD的患者在进入治疗后第一年的物质使用和心理健康结局以及医疗保健利用率。结果：PTSD患者和没有PTSD患者的治疗反应相似。尽管PTSD患者在进食时有较长的吸毒史，但在1年的随访中，他们发现海洛因，可卡因和酒精的使用减少，与无此病的患者相当。 PTSD患者接受了更高剂量的阿片类药物治疗，参加了更多针对药物滥用疾病的社会心理治疗，并且保留了更好的治疗药物。 PTSD患者的精神症状在摄入时更为严重，并且在整个治疗过程中几乎没有改善。结论：阿片类药物替代疗法在减少PTSD患者中的药物使用方面与没有疾病的患者一样有效，但是需要治疗成瘾的心理问题基本上没有改变的其他治疗服务。

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