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首页> 外文期刊>Journal of substance abuse treatment >The duration and correlates of addiction and treatment careers.
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The duration and correlates of addiction and treatment careers.

机译：成瘾和治疗职业的持续时间及其相关性。

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While addiction is increasingly recognized as a chronic condition, little information is available on the actual duration of addiction and treatment careers. The purpose of this study was to estimate the duration and correlates of years between (a) first use and at least a year of abstinence and (b) first treatment admission and at least one year of abstinence. Data are from 1,271 of 1,326 (96%) people recruited from a stratified sequential sample of admissions to publicly funded treatment programs in a large metropolitan area. Participants were interviewed at 6, 18, 24, 36, 48, and 60 months post-intake. With an average age at the referent intake of 35 (SD = 8) years, the sample is 59% female, 87% African American, 7% Hispanic, and 5% white. The most common dependence diagnoses were for cocaine (64%), alcohol (44%), opioids (41%), and/or marijuana (14%). Using lifetime substance use and treatment histories collected at intake and subsequent treatment utilization recorded during follow-up interviews, we conducted survival analysis to estimate the time from first use and first treatment until people reported 12 months of abstinence or died (with people still using, in treatment, or dead at the last follow-up treated as right censored). During the three years after intake, 47% reached at least 12 months of abstinence. The median time from first to last use was 27 years. The median time from first treatment episode to last use was 9 years. Years to recovery were significantly longer for males, people starting use under the age of 21 (particularly those starting under the age of 15), people who had participated in treatment 3 or more times, and for people high in mental distress. The exploratory results suggest that multiple episodes of care over several years are the norm and that rather than thinking of multiple episodes in terms of "cumulative dosage," it might be better thought of as further evidence of chronicity and that we need to develop and evaluate models of longer term recovery management.
机译：尽管成瘾日益被认为是一种慢性疾病，但关于成瘾和治疗职业的实际持续时间的信息很少。这项研究的目的是估计（a）首次使用和至少一年禁欲与（b）首次治疗入院和至少一年禁欲之间的持续时间和年数的相关性。数据来自在大都市地区从公共资助的治疗计划的分层连续入学样本中招募的1,326人中的1,271人（占96％）。参加者在摄入后6、18、24、36、48和60个月接受了采访。该样本的平均年龄为35岁（SD = 8），女性为59％，非裔美国人为87％，西班牙裔为7％，白人为5％。最常见的依赖诊断是可卡因（64％），酒精（44％），阿片类药物（41％）和/或大麻（14％）。利用在随访中记录的在摄入时收集的终生物质使用和治疗历史以及在后续访谈中记录的后续治疗使用情况，我们进行了生存分析，以估算从首次使用和首次治疗直到人们报告戒酒或死亡12个月（仍然使用，在治疗中，或在最后一次随访中死亡，视其为正确审查）。在摄入后的三年中，有47％的人禁欲至少12个月。从首次使用到最后使用的平均时间为27年。从首次治疗发作到最后一次使用的中位时间为9年。对于男性，开始使用21岁以下的人群（尤其是15岁以下的人群），参加过3次或以上治疗的人群以及精神困扰较高的人群，恢复时间要长得多。探索性结果表明，几年来多次发作是正常现象，与其说是“累积剂量”而不是多次发作，不如将其视为慢性病的进一步证据，我们需要发展和评估长期恢复管理的模型。

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