建置毒品施用者之復原與社會復歸：介紹美國物質成癮與心理健康服務部的定義與反思台灣現況

Recovery from substance use and returning to society: An introduction to SAMHSA's concept of recovery and recovery support and a reflection on current clinical practices in Taiwan

李宗憲(Tsung-Hsien Li) ； 白鎮福(Chen-Fu Pei) ； 束連文(Lien-Wen Su) ； 吳思穎(Szu-Ying Wu) ； 黃韻儒(Yun-Ju Huang) ； 林毓恩(Yu-En Lin) ； 顧以謙(Yi-Chien Ku) ； 李思賢(Tony Szu-Hsien Lee)

《藥物濫用防治》 6卷2期 (2021/06) Pp. 1-14

https://doi.org/10.6645/JSAR.202106_6(2).1

摘要

本文目的是提出協助毒品施用者復原／復歸社會的定義、工作目標與應包含的面向。復歸社會或社會復歸之類的詞彙，雖然經常出現在台灣毒品防制政策或對毒品施用者所提供的相關服務中，但其意涵對於提供服務之機構卻不盡相同。較積極性的復歸社會概念，實際上與美國物質成癮與心理健康服務部（SAMHSA）提出的復原／復歸社會（Recovery and Social Recovery）概念較為相近，依據其所定義的面向與相對應的指引，復原／復歸社會的四個面向包括健康、居住、生活目標與社區，並有十個服務的指引。本文提出在台灣對毒品施用者所提供的復原／復歸社會工作的建議，包含：（1）機構提供的處遇應有明確的目標與服務定位設定，確定服務對於個案社會復歸／復原所產生的影響，以及適合的個案類型。（2）服務方案應該有嚴謹的評估，確認不同類型的個案，接受實證研究建議之處遇措施，才能有效促進個案的復原。（3）復原是一個持續性、多面向的歷程，需要網絡資源的整合，以回應個案復原歷程的完整需求。（4）以個案為主體，視其需求與脈絡提供協助，幫助個案積極建構自我指導的生活，找到希望並努力發揮潛能。（5）建構協助毒品施用者社會復歸的社會／社區支持系統，讓社會發展成更和諧共榮的狀態。

關鍵字

毒品施用 ； 復原 ； 社會復歸 ； 服務機構

並列摘要

This paper aims to define the goals and indicators of recovery and social recovery when providing services to drug users. The concept of recovery and social recovery has been incorporated in antidrug policy and services related to drug use in Taiwan while there is a lack of consensus on its definition in current clinical practices. The concept of recovery and social recovery in a more proactive manner is same to the recovery proposed by Substance Abuse and Mental Health Services Administration (SAMHSA). According to SAMHSA, recovery and social recovery support involves four major dimensions, including health, home, purpose, and community, and ten principles that guide the work of recovery. Suggestions for services providers are as follows: (1) The providers should define their services and roles in the recovery process to monitor the outcomes and target the specific subpopulation that will be served; (2) To facilitate recovery, the providers should conduct a thorough case assessment and evaluation and offer efficacious services that are evidenced to meet the needs of the client; (3)Recovery is an ongoing and multifaceted process that requires a continuum of care and community resources to meet different needs in long-term recovery; (4)The services should be person-centered and be tailored to the context and clients' needs to promote self-directed life and help them reach their potentials in recovery; (5)Advocate for and develop a recovery-friendly society and communities that honor diversity and inclusivity.

並列關鍵字

Drug use ； Recovery ； Social recovery ； Services providers