云南省部分地区丁丙诺啡等多药滥用流行病学调查

目的:了解云南省丁丙诺啡等多药滥用的基本情况和滥用特征。方法:自行设计丁丙诺啡使用情况调查问卷,采用现况调查方法,由调查员对云南省4个州市的4种戒毒机构(强制戒毒所、劳教戒毒所、自愿戒毒机构和美沙酮社区维持治疗门诊)于2006年1月-2007年2月收治的海洛因滥用者进行一对一匿名填写问卷调查。结果:共收集有效问卷4452份,有1073份填写滥用过丁丙诺啡,占24.1%;有640份填写了丁丙诺啡等多药滥用史,占14.4%。丁丙诺啡等多药滥用者以21-40 a、初中文化程度(53.3%,341/640)、汉族(89.1%,570/640)、未婚(60.8%,389/640)、无业的男性为主(41.6%,266/640)。丁丙诺啡等多药滥用方式:静脉注射;滥用的主要原因为:"替代海洛因",占59.2%(379/640),"寻求舒服欣快感觉",占39.7%(254/640),"缓解对海洛因的渴求",占27.0%(173/640)和受同伴影响",占24.7%(158/640)。丁丙诺啡等药物的主要来源(所列比例均为人次百分比,多项选择题的结果):私人诊所:占83.3%、零售药店:占74.6%,医院:占73.7%,同伴提供:占65.2%,成人用品店:占13.0%。丁丙诺啡等多药滥用的危害:68.4%(438/640)出现过戒断症状;22.5%(144/640)出现过中毒休克症状。丁丙诺啡等多药滥用者的主观欣快效应分值明显高于丁丙诺啡单一滥用者的分值,统计学检验差异有显著性(P<0.01)。结论:云南省部分地区存在丁丙诺啡等多药滥用问题,滥用的原因主要是替代。丁丙诺啡等多药滥用已经给滥用者个体造成危害,建议有关部门采取有效措施遏制丁丙诺啡等多药滥用问题。

EPIDEMIOLOGICAL SURVEY OF BUPRENORPHINE POLY-DRUG ABUSE IN SOME DISTRICTS OF YUNNAN PROVINCE

Objective:To understand the basic information and characteristics of buprenorphine(Bup) in Yunnn Province.Methods:A questionnaire investigation on Bup abuse was conducted among heroin abusers who were doing treatment during Jan.2006 to Feb.2007 in 4 different types of detoxification institutions in 4 districts of Yunnan Province.Results:Altogether,4452 valid questionnaires were collected,among which 1073(24.1%) cases reported Bup use,and 640(14.4%) cases reported combined use with other drugs.For the combined users,they had the characteristics of young and middle aged male(21-40 a) with junior middle school education(53.3%,341/640),Han nationality(89.1%,570/640),unmarried(60.8%,389/640),no job(41.6%,266/640).Injection was the main route of drug administration.The reason for using was to substitute for heroin(59.2%,379/640),seeking for comfort and euphoria(39.7%,254/640),reduce craving for heroin(27.0%,173/640)and peer influence(24.7%,158/640).The main source of Bup and other drugs was private clinics,83.3%,drugstores,74.6%,hospitals,73.7%,friends,65.2%,and adult shop,13.0%.Many users(68.4%,438/640)encountered withdrawal syndromes and 22.5%(144/640) experienced poisoning and shocking.The VAS score of poly drug abusers was obviously higher than that of the single Bup users(P<0.01).Conclusion:There exists Bup and combined poly-drug abuse in some districts of Yunnan Province.Substitution for heroin contributes greatly to Bup abuse.Combined use of Bup has induced harm for individual users.We suggest that related agencies take effective interventions to control the problem.