甲基安非他命藥癮者治療預後因子分析－緩起訴二級毒品附命戒癮治療相關因素及性別差異分析研究

A Gender Difference Analysis of Factors Correlated with Treatment Outcomes for Methamphetamine Use Patients in a Deferred Prosecution Program for Drug Offenders

何玉娟(Yu-Juan Ho) ； 方素真(Su-Chen Fang) ； 陳辭一(Tzu-I Chen) ； 高君慈(Chun-Tzu Kao) ； 黃正誼(Cheng-Yi Huang) ； 洪嘉均(Chia-Chun Hung)

《中華心理衛生學刊》 35卷2期 (2022/06) Pp. 145-179

https://doi.org/10.30074/FJMH.202206_35(2).0003

摘要

研究目的：為探討影響甲基安非他命藥癮者完成治療之相關因素，並進行性別差異分析。研究方法：以2016-2018年北部某醫院二級毒品緩起訴附命戒癮治療藥癮者為研究對象，分為中斷治療及完成治療組。分析人口學、物質使用、精神及生理共病、尿液檢驗、衝動控制及改變階段，比較兩組和性別分組間之差異性，找出影響治療完成相關因子。研究結果：共納入916位甲基安非他命藥癮者，完成治療比例為76.3%。與未完成組相比，完成組年齡在35歲以上（p ＜ 0.05）、有伴侶（p ＜ 0.05）、有就業（p ＜ 0.05）的比例較高，衝動性較低（p ＜ 0.05）。完成組第一次驗尿陽性率（p ＜ 0.001）及同儕使用海洛因比率（p ＜ 0.05）較低。性別差異部分，影響女性藥癮者治療因子為年齡及衝動控制程度；男性藥癮者為伴侶狀態、飲酒史及衝動控制程度。研究結論：甲基安非他命使用者的年齡、伴侶狀態、就業、衝動控制、是否有使用毒品同儕、及第一次驗尿結果等因素與是否完成緩起訴治療相關。影響男女性藥癮者之因素略有不同。研究結果可作為未來設計藥癮治療方案之參考。

關鍵字

甲基安非他命 ； 緩起訴 ； 戒癮治療 ； 性別差異

並列摘要

Purpose: Methamphetamine abuse is a world-wide problem that lacks promising interventions. We designed this study to identify the factors associated with treatment outcomes for methamphetamine abuse patients participating in a deferred prosecution treatment program for drug offenders in Taiwan. Methods: We conducted a retrospective case-control study at a psychiatric center in northern Taiwan. We recruited 916 methamphetamine abuse patients by reviewing their medical charts. We examined whether any of the following factors related to treatment completion: demographic data, self-report substance use records, physical and psychiatric comorbidities, lab data, and behavioral measures (impulsivity and stage of readiness of change). Chi-square tests and logistic regression were applied to test for differences between the completion and drop-out groups, and for gender analysis. Results: The treatment completion rate was 76.3%. Compared with the drop-out group, the completion group was significantly older, and more likely to be married or in a relationship, to have a job, and to be less impulsive. The completion group also had a significantly lower positivity rate on their first urine test and a lower percentage of peer heroin use. Treatment completion by female methamphetamine users was significantly positively correlated with age and significantly negatively correlated with impulsivity; for male users, treatment completion correlated significantly positively with relationship status, and significantly negatively with drinking history and impulsivity level. Conclusion: Gender and impulsivity influence the treatment completion rate of methamphetamine users. The results provide information to tailor intervention programs for methamphetamine abuse patients.

並列關鍵字

methamphetamine ； deferred prosecution ； addiction treatment ； gender differences

參考文獻

吳其炘、廖士程、李宇宙 (2005)。衝動的精神病理學。台灣精神醫學，19，19–31 https://doi.org/10.29478/TJP.200503.0003

段永章 (2014)。緩起訴甲基安非他命戒癮治療參與者遵從門診治療之相關因素〔未出版之碩士學位學程論文〕。國立臺灣大學公共衛生研究所。https://doi.org/10.6342/NTU.2014.02489

陳俊興、黃明琪、沈武典 (2006)。某綜合醫院問題性飲酒者之改變動機調查。台灣精神醫學，20，201–211。http://doi.org/10.29478/TJP.200609.0005

劉子瑄、楊士隆 (2016)。毒癮司法戒治效果之性別差異研究。藥物濫用防治，1，1–26。https://doi.org/10.6645/JSAR.2016.1.1.1

劉明倫、黃孋娟、許鶯珠 (2008)。緩起訴毒品犯強制團體治療之退出相關因素。台灣精神醫學，22，278-286。https://doi.org/10.29478/TJP.200812.0004