甲基苯丙胺使用者成瘾行为发展阶段特征分析

目的:根据成瘾行为的发展过程对甲基苯丙胺使用者进行阶段划分，探讨不同阶段使用者的特点，为制订有针对性的临床干预措施提供理论参考。方法:以某强制隔离戒毒所2018年9月至2019年12月收治的男性甲基苯丙胺使用者作为研究对象，在其入所1周内完成临床诊断、访谈及问卷评估，研究对象按成瘾行为的阶段特征进行区分。使用视觉模拟评...

Characteric analysis of developmental stages about methamphetamine addictive behavior

Objective To differentiate the methamphetamine users according to the developmental stages of addictive behavior,and explore the characteristics of different stages in order to provid a theoretical reference for our clinical intervention.Methods Take the male methamphetamine users in compulsory detoxification institute whom were admitted from September 2018 to December 2019 as research objects.All the objects were asked to complete clinical diagnosis,interview and questionnaire evaluation in one week.According to the developmental stages of addictive behavior,the subjects were divided into occasional use group(n=51),regular use group(n=95)and compulsive use group(n=157).All subjects were evaluated using visual analogue scale(VAS),Barrett impulsiveness scale(BIS)and CogState scale.SPSS 20.0 software was used for statistical analysis,AVOVA or Kruskal-Wallis H test was used for group comparison.Multiple Logistic regression analysis was used to explore the factors associated with the development of addictive behavior.Results(1)The compulsive use group had higher cumulative duration(24(8,48),12(4,24),22(10,36)),average dose(6.6±3.8,2.8±1.4,4.5±3.4)and craving score(1(0,5),0(0,1),1(0,3))than the other two groups(all P<0.05).And individuals in compulsive use group had more previous heroin use experience(20.4%,9.8%,14.8%,P<0.05).The regular use group had more withdrawal times than the other two groups(1(1,3),1(0,1),1(1,2),P<0.05).The total scores of Barrett impulsiveness scale(42.8±13.3,34.5±13.6,36.1±14.9)and the scores in all dimensions in the compulsive use group were significantly higher than those in the other two groups(motor impulsiveness:37.5±15.8,27.8±13.4,29.2±17.8;attentional impulsiveness:43.2±18.0,39.4±17.0,37.2±18.1;non-planning impulsiveness:47.2±19.8,38.8±18.7,40.7±20.8;P<0.05).In the compulsive use users,the ISL(16.50±4.87,19.30±4.78,18.33±4.91)and SEC(0.76±0.21,0.89±0.22,0.81±0.21)scores about cognitive assessment were significantly lower than other two groups(both P<0.05).(2)The results of multiple Logistic regression analysis showed that cumulative duration(β=0.022,OR=1.022,95%CI:1.003-1.042),dosage(β=0.625,OR=1.869,95%CI:1.196-2.921),craving(β=0.194,OR=1.214,95%CI:1.002-1.215),the total scores of Barrett impulse scale(β=0.036,OR=1.037,95%CI:1.013-1.061),scores of non-planning impulsiveness(β=0.040,OR=1.041,95%CI:1.004-1.038),scores of motor impulsiveness(β=0.033,OR=1.214,95%CI:1.001-1.068)were associated with the periodic grouping of addictions.Conclusions Addictive behavior is a progressive process and methamphetamine users at different stages have different characteristics in substance use,impulsiveness and cognitive function.The development of addictive behavior is associated with the time,dosage and craving of substance use,as well as the personality impulsivity of users.And the compulsive users suffered more cognitive impairment than the other two groups.The methamphetamine users should be identified dynamically and targeted therapeutic intervention measures should be carried out to block the addictive process to achieve the goal of harm reduction.