觀察勒戒毒品犯之戒癮動機評估

Assessment of Motivations of Drug Addicts in Detention Centers to Change Their Addictive Behaviors

10.6288/TJPH2009-28-01-04

劉明倫(Ming-Lun Liu)；楊延壽(Yen-Shou Yang)；吳四維(Szu-Wei Wu)；吳承江(Chang-Chiang Wu)；許鶯珠(Ying-Chu Hsu)

觀察勒戒 ； 戒癮動機 ； involuntary detoxification in detention center ； motivation to change

台灣公共衛生雜誌

28卷1期（2009 / 02 / 01）

35 - 45

繁體中文

目標：探討毒品犯觀察勒戒制度的評估結果與毒品犯戒癮動機間的關係。方法：本研究評估470位接受觀察勒戒的毒品犯，以「觀察勒戒評估紀錄」及「戒癮動機階段評估表」為工具，由資深精神科醫師進行半結構式會談，進行動機狀態的評估與資料收集。結果：1.毒品犯戒癮動機以處於懵懂期最多(78.82%)；2.戒癮動機與有無繼續施用毒品傾向間無顯著相關；3.在11個評估項目中，僅「毒品犯罪相關司法紀錄」以及「戒斷症狀」兩個項目就解釋評估總分變異量的69%，但是只有「短期內再犯」與「注射使用毒品」兩個項目與戒癮動機間呈現顯著的相關。結論：目前觀察勒戒評估的結果，無法反應出毒品犯的戒癮動機，其中「毒品犯罪相關司法紀錄」以及「戒斷症狀」兩個項目評分比重過大，明顯影響繼續施用毒品傾向之判定，但這兩個項目與戒癮動機的關連性卻不顯著。未來在修訂評估分數時建議增加與動機有關連的「短期內再犯」與「注射使用毒品」兩個項目的評分比重。

Objectives: To evaluate the relationship between the tendency to relapse of drug addicts in detention centers and their motivation to change addictive behaviors. Methods: Semi-structured interviews using two instruments, the ”Relapse Tendency Assessment Record” and the ”Stage of Motivation Form,” were conducted by senior psychiatrists to assess 470 drug addicts. Results: 1. Most of the drug addicts were found to be in the pre-contemplation stage (78.82%). 2. The tendency to relapse and their motivation to change addictive behaviors were not significantly correlated. 3. Among the 11 assessment items, the ”drug-related criminal justice records” and ”withdrawal symptoms” accounted for 69% of the variance in tendency to relapse, but only ”short-term recidivism” (p＜0.05) and ”injection drug use” (p＜0.01) were significantly correlated to motivation to change. Conclusions: The tendency to relapse did not clearly reflect the drug addicts' motivation to change. The scores for the ”drug-related criminal justice records” and ”withdrawal symptoms” items were excessively weighted, had no significant correlation with motivation to change, and affected the result of assessment. In the future, we suggest more weighting of the scores for ”short-term recidivism” and ”injection drug use” in the ”Relapse Tendency Assessment Record” to increase the accuracy of the overall assessment.

1. Burdon WM,Messina NP,Prendergast ML.(2004).The California treatment expansion initiative: aftercare participation, recidivism, and predictors of outcomes.Prison J,84,61-80.
2. DiClemente CC,Hughes SO.(1990).Stages of change profiles in outpatient alcoholism treatment.J Subst Abuse,2,217-235.
3. Giovazolias G,Davis P.(2005).Matching therapeutic interventions to drug and alcohol abusers' stage of motivation: the clients' perspective.Couns Psychol Q,18,171-182.
4. Heather N,Rollnick S,Bell A.(1993).Predictive validity of the readiness to change questionnaire.Addiction,88,1667-1677.
5. Leon GD,Melnick G,Thomas G,Kressel D,Wexler HK.(2000).Motivation for treatment in a prison-based therapeutic community.Am J Drug Alcohol Abuse,26,33-46.
6. Maisto SA,Conigliaro J,McNeil M,Kraemer K,O''Conner M,Kelley ME.(1999).Factor structure of the SOCRATES in a sample of primary care patients.Addict Behav,24,879-892.
7. McLellan AT,Grissom GR,Zanis DA,Randall M,Brill P,O''Brien CP.(1993).Private substance abuse treat ment: are some programs more effective than others?.J Subst Abuse Treat,10,243-254.
8. Melnick G,DeLeon G,Thomas G,Kressel D,Wexler HK.(2001).Treatment process in prison therapeutic communities: motivation, participation, and outcome.Am J Drug Alcohol Abuse,27,633-650.
9. Miller WR,Rollnick S.(2002).Motivational Interviewing: Preparing People for Change.New York:Guilford.
10. Pantalon MV,Swanson AJ.(2003).Use of the University of Rhode Island Change Assessment to measure motivational readiness to change in psychiatric and dually diagnosed individuals.Psychol Addict Behav,17,91-97.
11. Prochaska JO,DiClemente CC.(1982).Transtheoretical therapy: toward a more integrative model of change.Theory Res Pract,19,276-288.
12. Rollnick S,Heather N,Gold R,Haju W.(1992).Development of a short "readiness to change questionnaire" for use in brief, opportunistic interventions among excessive drinkers.Br J Addict,87,743-754.
13. Thornton C,Gottheil E,Weinstein S,Kerachsky R.(1998).Patient-treatment matching in substance abuse: drug addiction severity.J Subst Abuse Treat,15,505-511.
14. 行政院衛生署、法務部、教育部(2005)。94年反毒報告書。
15. 毒品案件統計摘要
16. 陳珍亮(2006)。博士論文(博士論文)。嘉義，國立中正大學犯罪防治所。

1. 齊沛瑜、童伊廸、陳心怡、唐宜楨、王炯珵(2018)。K他命膀胱炎患者中止物質濫用歷程之探究。臺灣公共衛生雜誌，37(2)，206-219。
2. (2016)。毒品濫用及其戒治。月旦法學雜誌，258，116-131。
3. (2024)。成癮者復原力和治療成效相關因素之初探。社區發展季刊，185，407-423。
4. (2024)。從毒癮犯罪者在精神醫學之本質談其犯罪預防之保安處分運用。刑事政策與犯罪防治研究專刊，38，149-190。