碩士 / 高雄醫學大學 / 醫務管理學研究所碩士在職專班 / 97 / Background:
An increasing number of people have become infected with HIV/AIDS in recent years. Between 1984 and 2007, more than 15,000 AIDS cases were reported. Among them, cases related to drug addiction accounted for 38.54%, making it the number one risk factor. Analysis reveals that heroin addicts who share needles comprise the majority of people becoming infected with HIV. To tackle the spread of AIDS, the Department of Health (DOH) in December 2005 launched a “Pilot Program of AIDS Harm Reduction to Drug Abuser” and introduced Methadone Maintenance Treatment (MMT). Though we are now able to control the spread of AIDS to a certain extent, the harm caused by heroin addiction is no less devastating than losing the battle against AIDS. The impact that drugs have on public security, the economy, society and families is no less than that of AIDS, with even worse consequences. MMT is still new to Taiwan, and the fact that most people are unfamiliar with this treatment may have a negative impact on the implementation of the country’s drug policies. Consequently, this study discusses and analyzes the effectiveness of MMT, with suggestions put forward for reference by relevant government agencies.
Objective:
This study discusses and analyzes irrational beliefs toward heroin addicts and their social function disability, as well as the effectiveness of MMT.
Methods:
The study was conducted using a quasi-experimental design. The subjects were divided into two groups – intervention and comparison groups. Those in the intervention group (G1) were heroin addicts receiving MMT at the psychiatric outpatient department of a regional hospital between January and December of 2007, and those in the comparison group (G2) were heroin addicts in the custody of a district prosecutors’ office in the same period for violating the drug abuse prevention statute. Our first step was to code data and create files using Microsoft Excel 2000. Then we compiled statistics and analyzed them based on our study framework and hypotheses to identify the drug addicts’ special demographic attributes, such as age, level of education, marital and employment statuses, and drug abuse behavior such as drug abuse history and previous convictions. Two separate questionnaires were filled out by subjects in both groups to quantify their beliefs toward drug abusing and social function at the beginning and the end of three-month period. The questionnaire for quantifying the subjects’ beliefs toward drug abuse comprises three parts – expectancy, self-abasement with drug dependence and underestimation of drug addiction. Results obtained at the beginning and end of three-month period of the same group were compared and analyzed. And the questionnaire for quantifying the subjects’ social function consists of five parts – interpersonal relations, achievements, time allocation, family life and flexibility. Results obtained at the beginning and end of three-month period of the same group were also compared and analyzed. In addition, results obtained from the two groups were compared to find out their differences in order to evaluate the effectiveness of the MMT. In this study, the Chinese version of the statistics application SPSS 12.0 for Windows was used to compile descriptive and deductive statistics.
Results:
There were 81 subjects in G1 and 34 in G2. 14 questionnaires handed in by subjects in G1 and 13 by those in G2 were considered invalid and excluded from the study, leaving 67 valid questionnaires in G1 and 21 in G2. The average age at which the subjects began using heroin was 25.25±6.07 in G1 and 28.05±10.93 in G2, for an average of 11.40±6.15 and 12.57±4.72 years, respectively. The average number of previous conviction per subject was 1.97±1.54 in G1 and 4.00±2.15 in G2. There are no obvious differences between the two groups in terms of demographic attributes and drug abuse history. However, an examination of previous convictions reveals a noticeable difference between them. Consequently, the variable was placed under control throughout the deduction process. Paired t test was utilized in both groups to measure the difference in the points scored between the beliefs toward drug abuse questionnaires filled out at the beginning and end of three-month period. In terms of beliefs toward drug abuse, the results are: expectancy – G1: p<0.0001, G2: p=0.480; self-abasement with drug dependence – G1: p<0.0001, G2: p=0.355; and underestimation of drug addiction – G1: p<0.0001, G2: p=0.940, with the combined score being G1: p<0.0001, G2: p=0.511. As far as social function are concerned, the results are: interpersonal relations – G1: p<0.0001, G2: p=0.506; achievements – G1: p<0.0001, G2: p=0.658; time allocation – G1: p<0.0001, G2: p=0.803; family life – G1: p<0.0001, G2: p=0.083; and flexibility – G1: p<0.0001, G2: p=0.366, with the combined score being G1: p<0.0001, G2: p=0.740. In addition, repeated measure two-way ANOVA was used to analyze the interaction between the two groups with questionnaires filled out at the beginning and end of each period. In terms of beliefs toward drug abuse, the score is: p<0.0001, indicating that subjects receiving MMT suffered less from beliefs toward drug abusing. The results obtained from the three parts of this questionnaire are: expectancy – p<0.0001, self-abasement with drug dependence – p<0.0001, and underestimation of drug addiction – p<0.0001. As far as social function are concerned, the score is p=0.001, indicating that subjects receiving MMT can improve their social function. The results obtained from the five parts of this questionnaire are: interpersonal relations – p=0.240, achievements – p=0.010, time allocation – p=0.001, family life – p=0.006, and flexibility – p=0.014.
Conclusions and Suggestions:
According to the study results, most of them began using drugs when they were young.Those who became addicted had used drugs for more than ten years. Once becoming addicted to heroin, it is very difficult to abstain. Even those who manage to abstain are prone to relapse, resulting in multiple drug convictions.Heroin addicts are faced with many physical and psychological problems, which have wide-ranging impacts on public hygiene, economy and security of society in general.It is suggested that the national health insurance pays for the treatment of drug addiction.The public should be educated to eliminate their misunderstandings about drug addiction and reduce the repulsion experienced by drug addicts. Efforts should be made to avoid paying too much attention to the ethical issues surrounding drug addiction to avoid polarization. The government should also continue to subsidize MMT in order to lower the threshold for the treatment and allow more drug abusers to receive MMT. A platform should be established to provide drug abusers with friendly consultations and caring treatment. The government is advised to consider obtaining drug offenders’ consent to receive MMT as a condition of granting probation or parole. It is also advised to set up drug courts and promote a community-based drug abstinence model in order to improve abstinence effectiveness, reduce waste of resources and establish a healthy society far away from drug hazards.
| Identifer | oai:union.ndltd.org:TW/097KMC05528023 |
| Date | January 2009 |
| Creators | Wen-Cheng Chin, 秦文鎮 |
| Contributors | Yong-Yuan Chang, 張永源 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 132 |
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