五省市吸毒人群中复方地芬诺酯使用情况调查

目的:调查吸毒人群使用复方地芬诺酯的现况、一般用药情况、用药目的及药物滥用潜力。方法:自行设计调查表,于2008年3月-7月,在北京、上海、广东、广西、山西等五个地区的戒毒所或社区美沙酮维持治疗门诊对戒毒人员或参加美沙酮维持治疗人员进行调查。采用视觉类比量表(VAS)评分评价使用复方地芬诺酯所产生的欣快效应。结果:在1147例有效被调查者中,有使用复方地芬诺酯经历者343例(占29.9%),全部为海洛因成瘾者,以31-40 a(占44.0%)、男性(占75.2%)、无业和个体经商(分别占30.1%和31.3%)、初中文化程度(占55.9%)以及已婚者(47.9%)为主。复方地芬诺酯的平均用量为8片.次-1,2次.d-1;75.5%为超常规大剂量用药者;98.8%以口服方式用药;73.6%从药店购买;20.8%同时合并使用其他药物;使用复方地芬诺酯的主要目的是"自行戒毒"(占88.0%)。VAS评分显示,滥用海洛因时产生的欣快感平均为6.2 cm,单独使用复方地芬诺酯时产生的欣快感平均为0.1 cm,两者比较有统计学差异(P<0.001)。根据每日用药剂量分组比较,超常规大剂量使用者产生的欣快感大于常规剂量用药者(P<0.05);且经Spearman等级相关分析显示,复方地芬诺酯的用量与欣快感之间存在正相关(P<0.05)。合并其他药物使用的欣快感大于单独使用(P<0.001)。结论:本调查人群中使用复方地芬诺酯主要目的是自行戒毒,大部分人属于非常规的大剂量用药。虽然该药的精神依赖性潜力不强,但大剂量使用或合并用药后会增加其滥用潜力。

USE OF COMPOUND DIPHENOXYLATE TABLETS AMONG HEROIN USERS IN CHINA FIVE AREAS

Objective:To understand the characteristics of Compound Diphenoxylate tablet use among drug users.Methods:A survey was conducted among 1147 drug users collected from March to July,2008 at the drug detoxification & rehabilitation centers or methadone maintenance treatment clinics in 5 different areas,Beijing,Shanghai,Guangdong,Guangxi and Shanxi with a self-designed questionnaire.Visual Analogue Scale(VAS) was used to evaluate the euphoria of the drugs related.Results:Among the 1147 drug users,343 used Compound Diphenoxylate tablets(29.9%),all of whom had been heroin addicts.Middle aged(31-40 years old,accounting for 44.0%),males(75.2%),no job(30.1%)or doing individual business(31.3%),received middle school education(55.9%) and married(47.9%)were their main demographic characteristics.The average use of Compound Diphenoxylate tablets was 8 tablets a time,twice a day;75.5% were overdose users.The main use route was oral administration(98.8%).The main source of Compound Diphenoxylate tablets was pharmacies(73.6%).20.8% used Compound Diphenoxylate tablets with other drugs simultaneously,and 88.0% used the drug for self-detoxification.VAS evaluation showed that the average values of euphoria when used heroin alone and used Compound Diphenoxylate tablets alone were 6.2 cm and 0.1 cm,respectively,indicating a significant difference(P<0.001) when compared with each other.There was a significant positive correlation between the amount of Compound Diphenoxylate tablet use and euphoria(P<0.05),with the overdose users experiencing greater euphoria than the therapeutic dose users(P<0.05).There was also significant difference(P<0.001) between single Compound Diphenoxylate tablet users and users combined with other drugs.Conclusion:Compound Diphenoxylate tablets are used mainly for drug detoxification among drug users in the surveyed areas.Most are overdose users.Compound Diphenoxylate tablets may have low drug abuse producing potential,however,overdose use and combined use with psychotropic substances may increase its drug abuse potential.