本研究為台灣第一篇以多中心為研究場域進行之 MMT 研究，本研究顯示參與 MMT 研究海洛因治療的患者為高共病症，高 HIV 盛行率，高 HCV 盛行率，高犯罪紀錄 的複雜族群，可從此流行病學結果瞭解為何以往嘗試想治癒此類患者的諸多治療方 式均無良好成果，減害治療模式乃因應而生。
不同治療環境之差異
本研究顯示不同治療環境之差異，中山醫學大學附設醫院與草屯療養院各代表醫學 中心及精神科專科醫院的差異，也代表城市與鄉鎮治療環境之差異，結果顯示兩者 在諸多特質上有所差別，顯示任何 MMT 研究若只選擇一中心，其結果推論將受到 明顯選項偏差所侷限，因此本研究顯示多中心的 MMT 研究有其研究法上之重要性。
心理社會特質
就心理社會特質方面，本研究發現和以前研究相近(Rounsaville et al, 1982; Brooner et al, 1997)，有高比例的共病性，和台灣以往研究相比較，之前江等人(Chiang et al., 2007) 發現有 34.2%的人有第一軸非物質之精神疾患，最多的是泛焦慮症（28.5%）
及重鬱症（16.8%），本研究為 26.7%的人有第一軸非物質之精神疾患，最多的是 25.2%的重鬱症，相近其結果但仍有些差異，如較高的憂鬱症及較少的焦慮症。此 共病性和海洛因使用的關連性可能是兩者有共通致病機轉，精神疾病會造成海洛因 使用或海洛因會造成精神疾病，其關連性需要長時間世代研究證實。而高精神疾病 之共病性會影響物質依賴者之治療結果，比如憂鬱即是海洛因治療預後較差之危險 因子（Rounsaville et al, 1982; kosten et al, 1986），因此在 MMT 治療中診斷治療精神 疾病共病性，尤其是憂鬱症之治療是重要課題。
成癮嚴重度
本研究和以往西方報告一致，顯示成癮嚴重度（以 SDS-C 的總分呈現） 和
犯罪行為(Barrio et al., 2001)，憂鬱程度(Feeney et al., 2005)，海洛英使用量(Barrio et al., 2001; Ferri et al., 2000; Gossop et al., 1995)相關，本研究更進一步發現其和生理範 疇之生活品質，心理範疇之生活品質，一年有自殺意念，差的家庭支持度相關，顯 示成癮嚴重度的評量是 MMT 評估的重要指標，而以往研究顯示 SDS 的分數和將來 的治療預後相關（McCamant et al, 2007），此值得做將來的長期追蹤指標。
HIV, HCV
本研究顯示此族群有高 HIV 的盛行率，其中和以往一致的相關因子有與他人共用 注射準備工具，注射方式及犯罪前科(Barrio et al., 2007)，但未發現性別及教育程度 的差異，此外發現有他人共用注射針頭/空針，無業，輕躁症，創傷後壓力症候群 的差異。其中創傷後壓力症候群在 MMT 的 HIV 個案的研究非常少，值得將來進一 步的探討。
本研究顯示此族群有極高 HCV 的盛行率(84.6%)，相近於最近香港(Lee et al., 2008) 的研究(85%)及台灣的研究（89%）(Chu et al., 2009)，高於另一台灣的資料(74.9%) (Liao et al., 2006)，其中注射天數，注射方式為相似之相關因子，但本研究未發現共 用針頭為危險因子(Liao et al., 2006)，而發現過去較少討論的因子包括平均給藥劑 量，低教育程度，生活事件，ADHD 嚴重度，cholesterol，無業，毒品前科，此值 得將來再進一步的研究。
前科相關因子
本研究顯示 87.4%有毒品前科，57.9%有非毒品前科，藥癮前科相關因子：未婚，
低教育程度，低 cholesterol， 喝酒天數，生活事件數，輕鬱症，躁鬱症，泛焦慮症，
非藥物前科，HIV，HCV。而非藥癮前科相關因子：社交恐懼症，HIV，藥癮前科，
男性，SDS，戒癮次數，社會範疇之生活品質，環境範疇之生活品質。澳洲一研究 (Ross et al., 2005)顯示一個月內的犯罪盛行率為 55%，男性和女性機率相似，而和 物質濫用的藥物總類總和數目相關。而經治療後可持續在治療模式中的人會降低其 犯罪行為(Campbell et al., 2007)。本研究呈現更豐富的相關因子，而這些因子對於 將來在犯罪的相關姓是值得追蹤研究的項目。
海洛因使用者腦部影像之研究:
本研究的海洛因使用組與健康對照組的 brain MRI 影像皆無明顯的腦部損傷，主要 是因為篩選這些研究樣本的包含與排除條件，已明定這些個案皆須排除體內有任何 受術後留下的金屬合成物、無腦部重大的生理疾病、所有個案的年齡不高(在 27 歲 到 45 歲之間)。檢定海洛因使用組與健康組在 brain DT-MRI 之各圈選區域白質的
FA，海洛因使用組與健康組兩組在 right temporal white matter(FA=0.433, FA=0.506) 及 left temporal white matter(FA=0.445, FA=0.506)的 FA 值檢定上，則皆呈現統計上 的顯著差異(p=0.000, p=0.000)，而且海洛因使用組的平均 FA 值均較健康組為低，
此結果說明：海洛因使用的病人可能在雙側的顳葉白質(temporal white matter)的神 經纖維出現微細結構的病變(microstructual change)。大腦白質形成大腦結構上的主 要部分，而大腦白質內的神經徑路的瓦解會導致腦部功能異常，進而表現出臨床症 狀。本研究顯示海洛因使用的病人可能在顳葉白質的神經纖維出現微細結構的病 變，而顳葉在情緒上與動機上的行為(emotional and motivational behavior)扮演一重 要角色，若是顳葉受損則正常焦慮與害怕的反應出現障礙(Kluver et al., 1939)，所以 推論海洛因使用者可能的顳葉受損，與其高犯罪率、高復發率、高危險行為的現象 也許有關聯，也許未來需要更多的不同研究做進一步的探討
本部份的研究限制：主要在於研究樣本數少，原因主要為海洛因使用者受研究評 估的意願不高、研究時間與經費受限等因素。而樣本數少也造成本統計檢定上容易 增加 type II 偏差。
六、計畫成果自評
本研究以雙中心的樣本提供較具代表性的結果，其結果顯示多中心研究有其必要 性，此外本研究團隊擁有自己完成信校度和國際接軌（WHO 官定版本）的重要評估 工具（SDS-C），其結果可以和國外做一比較，此外本可提供精神疾患之診斷研究選 用結構式問卷（MINI），可提供精神疾患之診斷，而詳盡的評估變項可提供豐富的臨 床資料。其缺點為受經費所限，只呈現橫斷型資料，而非世代研究資料，使得變項 間的關係只有相關性而無法推論為因果關係，因此繼續追蹤的研究，探討 MMT 治 療療效因子將是將來努力的目標。
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