台湾地区在校青少年药物滥用盛行率与危险因子的探讨

从我们一系列的研究中发现 ,台湾地区青少年用药以苯丙胺类占绝大多数 ,而只有少数人吸食强力胶 (挥发性溶剂类 )、大麻、海洛因等。但１０多年前的研究指出 ,强力胶为最常滥用的药物。这种药物滥用变化的趋势值得重视。有研究指出 ,在１５ａ以前使用药物者 ,其日后愈易染上吸毒的习惯。故吸烟、饮酒、药物滥用被公卫学者认为是药物成瘾之“三部曲”。在烟酒这两种被认为是吸毒入门药的逐步泛滥下 ,药物滥用的灾难已隐隐欲现。从预防医学３个阶段的预防模式而言 ,药物滥用防治的第一阶段的预防为“增进健康及特殊防护” ,主要在鉴定出哪些生…     

Drug abuse in Asia

The article focuses on countries and areas of South-East Asia, which are seriously affected by drug abuse and the problems associated with it. Opium has traditionally been used for treating illnesses and alleviating physical and mental stress, as well as for recreational and social purposes. The prohibition of the sale and use of opium in Burma, Hong Kong, Malaysia, Singapore and Thailand forced many habitual opium users to switch to heroin. Over the past two decades there has been an increasing trend towards drug use, often involving experimentation with more than one substance, among youth in and out of school. For example, a survey of students at teachers' colleges in northern Thailand showed that at some time in their lives 30-40 per cent of the male respondents and 3-6 per cent of the female respondents had used cannabis, and that 18-20 per cent of the males and 12-27 per cent of the females had sniffed volatile solvents. The same survey showed that 5-10 per cent of both the males and females had used stimulants and nearly 2 per cent had used heroin. During the 1970s the abuse of heroin and other opiates emerged as a serious problem of epidemic nature, predominantly affecting young people in many countries of South-East Asia. While opiates, including heroin, have been abused by inhaling and by smoking, there has recently been an increasing trend towards injecting heroin of high purity (80-90 per cent pure heroin). Heroin addiction spread first to the populations of capital cities and then to other cities and towns and even to the hill tribes, as studies in Thailand have revealed. Most recent studies have shown that heroin abuse has spread further in Asia, both socially and geographically, involving such countries as India and Sri Lanka, which had no previous experience with the problem. Studies have also shown that the abuse of manufactured psychotropic substances has been increasing and that heroin addicts resort to these substances when heroin is difficult to find. The article also briefly reviews the history of opium use in China and the history of drug abuse in Japan, particularly with regard to the problem of methamphetamine abuse, which has appeared in two epidemic-like waves. The first followed the end of the Second World War and disappeared at the end of the 1950s; the second reappeared in 1975 and since then has gradually been increasing in size.     

Drug utilisation in Dutch nursing homes

Objective: To quantify and evaluate drug utilisation in a sample of Dutch nursing homes. Methods: A retrospective analysis of computerised medication data of 2355 residents aged 65 years and over from six nursing homes in the Netherlands was performed. For each therapeutic drug group, the number of users was determined. The ten therapeutic groups used most frequently were investigated further. For these, patient characteristics, use of therapeutic subgroups, the average daily dosages and the chronicity of drug use were determined. Chronicity was expressed as the percentage of treatment days divided by the number of residents' days in the nursing home. Results: During the study period, 89%, 77% and 56% of the study population used a drug from the anatomical therapeutic chemical (ATC) main group N (nervous system), A (alimentary tract and metabolism) and C (cardiovascular system), respectively. Eight of the ten therapeutic drug groups prescribed most frequently were used for more than 50% of the time. In particular, psycholeptic drugs, diuretics and laxatives were used chronically (83%, 81%, and 80% of the nursing home stay, respectively). Except for a few drug groups, such as laxatives and diuretics, the prescribed daily dosages were relatively low. Twenty-eight percent of the residents received loop diuretics; these were prescribed in relatively high dosages. Conclusion: Drug utilisation in the nursing homes was high and many drugs were used chronically. In view of the risk of possible adverse effects and drug–drug interactions, the prescribing and dosage of psycholeptic drugs, laxatives, loop diuretics and ulcer-healing drugs should be re-evaluated, carefully. Received: 11 March 1999 / Accepted in revised form: 19 September 1999     

Cardiovascular drug use among people with cognitive impairment living in nursing homes in northern Sweden

European Journal of Clinical Pharmacology - The aim of this study was to describe changes in the pattern of cardiovascular agents used in elderly people living in nursing homes between 2007 and...     

Drug abuse in Africa

Apart from cannabis abuse in northern and southern Africa and khat chewing in north-eastern Africa, the history of drug abuse in Africa is relatively short. The abuse of drugs in Africa is nevertheless escalating rapidly from cannabis abuse to the more dangerous drugs and from limited groups of drug users to a wider range of people abusing drugs. The most common and available drug of abuse is still cannabis, which is known to be a contributing factor to the occurrence of a schizophrenic-like psychosis. The trafficking in and abuse of cocaine and heroin are the most recent developments in some African countries that had had no previous experience with these drugs. Efforts should be made to design and implement drug abuse assessment programmes to determine the real magnitude and characteristics of the problem and to monitor its trends. A lack of funds and a shortage of adequately trained personnel have made it difficult to implement drug abuse control programmes. In addition to formal drug control involving the implementation of legislation, there is an informal system of drug abuse control operating through the family, church, school, neighbourhood and work environment, as well as healthy recreational activities. It is suggested that efforts in African countries should be directed towards strengthening not only the formal drug control system but also informal control in order to compensate for the insufficient funds and the shortage of personnel trained in implementing formal drug control measures. It is very likely that the drug problems in African countries will worsen in future unless more effective measures are implemented to arrest the current situation.     

门诊中心治疗经验谈

１门诊中心治疗模式门诊戒毒中心为澳门特别行政区政府社会工作局防治药物依赖厅辖下特设的“专业治疗中心” ,是唯一由政府提供的戒毒治疗机构 ,主要由戒毒复康处管理。由社工辅导员、临床心理学家、精神科医生和专业护士组成专责治疗小组 ,对自愿求助者的各项困难给予协助。其服务内容主要由社工辅导员为个案作深入的治疗评估 ,制定适合的治疗计划 ,并提供配套治疗 ,包括生理戒断、动机激励、情绪支持和辅导、经济援助、医疗护理、家庭重塑、以及重返社会培训等等。一般而言 ,求助者由社工辅导员接见 ,进行评估 ,再安排具体的医疗戒毒时间…     

Association between substance abuse problems and antisocial tendencies in male juvenile delinquents: A study using the Psychopathy Checklist, Youth Version]

AIMS: We examined an association between substance abuse problems and antisocial tendencies in male juvenile delinquents. METHODS: Subjects were 57 male adolescents consecutively incarcerated between December 2004 and February 2005 in a juvenile classification home. A self-reporting questionnaire was used to assess substance abuse problems in the subjects: Drug abuse problems were assessed by the Drug Abuse Screening Test (DAST-20), and alcohol abuse problems were assessed by the Quantities-Frequencies Scale (QFS). A semi-structured interview was also preformed according to the Psychopathy Checklist, Youth Version (PCL: YV). Associations between questionnaire responses and interview findings were examined using Pearson's correlation or Spearman's rank correlation test. RESULTS: Of our subjects, the 17.5% were recognized as a problematic drug abuser, and the 52.6% as a problematic drinker. Neither of the total DAST-20 nor QFS score was significantly correlated with the total PCL: YV score, and also with each score of the four PCL: YV subfactors. However, significant correlations were found between some items on the PCL: YV and the DAST-20 or QFS score. The DAST score was significant correlated with the PCL: YV item, "impression management" (rs=0.35, p<0.001), and the QFS score was significant correlated with "serious violations of conditional release" (rs=0.33, p<0.05) and "criminal versatility" (rs=0.48, p<0.001). CONCLUSION: More than a half of male juvenile delinquents had alcohol abuse problems. Alcohol intake may be considered to promote repetition and diversification of their antisocial behaviors, although overall antisocial tendencies were not associated with drug and alcohol abuse problems in male juvenile delinquents.     

Co-occurrence of substance abuse with conduct, anxiety, and depression disorders in juvenile delinquents.

The purpose of the current study was to examine the co-occurrence of substance abuse and three other psychiatric disorders (conduct disorder, depression, anxiety) in an incarcerated juvenile delinquent sample. Diagnostic interviews were utilized to place participants in one of three groups: No substance abuse, alcohol/marijuana abuse, or polysubstance abuse. Frequency of diagnosis and number of symptoms of three psychiatric disorders were then examined. The results indicated that the diagnosis of conduct disorder increased significantly with the occurrence of substance abuse. Also, the number of symptoms for conduct disorder, anxiety, and depression increased with substance abuse. With polysubstance abuse the probability of having more than one of the other psychiatric diagnoses was above 50%. Potential explanations for the findings, focusing on the developmental trajectory for conduct problems and self-medication for internalizing disorders, are discussed.