- 期刊
COVID-19大流行期間對戒癮治療服務及藥物使用者的影響
The Impacts on Addiction treatment Services and Substance Abusers during the COVID-19 Pandemic
摘要
COVID-19大流行對全球造成了嚴重影響，後續效應對戒癮醫療機構的運作構成了挑戰，特別是在疫情下如何提供穩定且高品質的戒癮治療服務，並維持成癮患者的治療效果，已經成為全球在後疫情時代所檢討的重要議題。相對於國際文獻，我國相關本土研究較少著墨於COVID-19大流行期間對戒癮治療服務及藥物使用者的影響。為彌補本土文獻上的空白，本研究以各縣市醫院、療養院從事美沙冬替代療法及緩起訴附命戒癮治療執行人員，以及在毒品危害防制中心協助藥物使用者追蹤輔導服務的個案管理師為研究對象，採質性研究中的深度訪談法進行，共訪談10位提供藥癮治療服務者，藉此充分了解COVD-19大流行對於我國戒癮治療服務及藥物使用者的影響。研究結果顯示，大流行期間，藥物使用者的生理與心理健康受損，染疫風險與重症發生率顯著提升，長期施用藥物的群體面臨交互傳染與診斷困難的挑戰。心理方面，隔離政策加劇焦慮、憂鬱與孤立感，家庭衝突及工作不穩定進一步影響其生活穩定性與戒癮意願。在戒癮治療服務方面，美沙冬替代療法受限於疫情影響，取藥不便性增高，部分地區實施送藥到府、設置戶外門診及專門時段，然而部分醫療機構因資源限制中止服務，阻礙治療連續性。緩起訴附命戒癮治療則因門診與團體治療暫停，妨礙個案向醫院報到，有些地檢署會隨疫情狀況調整撤銷緩起訴力度。毒品危害防制中心則全面取消家訪與面訪，改以電話聯繫，但因聯繫難增加導致個案支持不足。根據上述研究發現，本研究提出四項建議：提供更安全且彈性的戒癮治療服務、實施遠距醫療、加強各政府部門間的資源整合及推動醫療轉型計畫，從而更靈活地應付未知流行病挑戰，以提升藥物使用者的健康及福祉。
並列摘要
The COVID-19 pandemic has exerted profound global impacts, posing significant challenges to the operation of addiction treatment institutions. Ensuring stable and high-quality addiction treatment services while maintaining therapeutic efficacy for individuals with substance use disorders has emerged as a critical issue in the post-pandemic era. Compared to the extensive body of international literature, there remains a scarcity of localized research in Taiwan addressing the pandemic's effects on addiction treatment services and substance abusers. To fill this gap, this study employs qualitative in-depth interviews targeting healthcare professionals engaged in methadone maintenance therapy and Deferred Prosecution with Condition to Complete the Addiction Treatment across hospitals and rehabilitation centers, alongside case managers providing follow-up and counseling services at Drug Abuse Prevention Centers. A total of 10 treatment providers were interviewed to comprehensively explore the pandemic's impact on Taiwan's addiction treatment services and substance abusers. The findings revealed significant physical and mental health deterioration among substance abusers during the pandemic, with heightened infection risks and severe illness rates. Long-term drug users faced challenges such as cross-infections and diagnostic difficulties. Psychologically, isolation policies exacerbated anxiety, depression, and loneliness, while family conflicts and job instability further undermined their life stability and willingness to seek addiction treatment. Regarding addiction treatment services, methadone maintenance therapy was disrupted, resulting in increased difficulties accessing medication. Some regions implemented measures such as home medication delivery, outdoor clinics, and dedicated service hours, but resource limitations forced some institutions to suspend services, disrupting treatment continuity. Deferred Prosecution with Condition to Complete Addiction Treatment was similarly affected, as clinic closures and suspended group therapy sessions hindered attendance at medical appointments. Adjustments to the withdrawal of deferred prosecution were made by some prosecutors' offices based on the pandemic situation. At Drug Abuse Prevention Centers, home visits and in-person services were completely replaced by phone contact, but communication challenges limited effective support for clients. Based on these findings, the study proposes four recommendations: improving safe and adaptable addiction treatment services, introducing telemedicine, promoting interdepartmental integration of resources, and promoting health system transformation initiatives to respond more flexibly to the challenges of unknown epidemics to improve the health and well-being of drug users.