我国苯丙胺类兴奋剂和K粉滥用人群用药后症状及戒断症状分析

SYMPTOMS,SIGNS,BEHAVIORS AND WITHDRAWAL SYMPTOMS OF AMPHETAMINE- TYPE STIMULANTS AND KETAMINE IN CHINA

目的:了解目前我国苯丙胺类兴奋剂(ATS)和K粉(主要成分为氯胺酮)滥用的基本情况及滥用后出现的症状、体征/行为和戒断症状的特点。方法:采用自拟调查问卷从2010年3月-2010年12月对北京、上海、云南、广东、湖南和湖北等地的强制隔离戒毒所或社区内的以滥用甲基苯丙胺(MA)、"摇头丸"(MDMA)、K粉或者"麻谷丸"为主的合成毒品滥用者进行回顾性调查,并统计分析人口学特征、合成毒品滥用情况、成瘾性、用药后的症状、体征/行为和戒断症状。结果:共调查1459名滥用者,男性占65.17%,平均年龄为(32.87±8.78)岁。将调查对象按主要滥用毒品种类分为三组:ATS(滥用主要毒品包括MA或MDMA或"麻谷丸")的有1191人(83.93%),K粉的有141人(9.94%),混用ATS+K粉的有87人(6.13%)。通过因子分析将用药后出现的症状、体征/行为归为6组症状群。有98.21%(1318/1342)的合成毒品滥用者出现了一定的用药后症状、体征/行为;兴奋症状在三组滥用人群中均最为严重,其中ATS和ATS+K粉前三位症状为失眠、兴奋和欣快,K粉为欣快、兴奋和失眠;第二位症状群在ATS和K粉中均为躯体症状,而ATS+K粉则为精神病性症状;且ATS+K粉的兴奋症状、精神病性症状,躯体症状和行为紊乱比ATS和K粉者严重。有90.88%(1215/1337)合成毒品滥用者停药后出现了一定的戒断症状,常出现的是用药渴求、困倦、疲乏无力、嗜睡、注意力不集中等。用药渴求在K粉和ATS+K粉中最为严重(排序第1位),在ATS中排名第4位,ATS中最为严重的戒断症状是困倦。结论:目前我国ATS和K粉的滥用状况具有不同的特点,并且用药后的症状和戒断症状在滥用ATS、K粉及混用两者的人群中存在差异,应根据各自特点制定相关的预防措施和治疗手段。

Objective：The aims of our research are to understand the characteristics,symptoms and withdrawal symptoms of amphetamine type stimulants（ATS） and ketamine abstainers in China.Methods：A retrospective research was carried out with a self- designed questionnaire on the synthetic drugs abstainers in the forced or community detoxification and rehabilitation centers in Beijing,Shanghai,Yunnan,Guangdong,Hunan and Hubei from March to December 2010.We investigated and analyzed the demographic characteristics,the type of abused synthetic drugs,symptoms,addiction and withdrawal symptoms.Results：Among the 1459 subjects,65.17%are male and the mean age is（32.87 ±8.78） years.There are 1191（83.93%） participants abused ATS-only,141（9.94%） participants abused ketamine-only and 87（6.13%） participants abuse ATS ＋kemaine.Using factor analysis,we classified the symptom into six symptom syndrome.There are 98.21%（1318/1342） synthetic drug abusers having at least one symptom after abusing.Excited sympotom has the highest scores in both ATS- only,ketamine- only and ATS ＋ ketamine group,and the first three symptoms are insomnia,excitment and euphoria in both ATS and ATS ＋ ketamine group,while in ketamine group are euphoria,excitment and insomnia.Moreover,somatic symptoms rank the second in ATS- only,ketamine- only group,while psychotic symptoms rank the second in ATS ＋ ketamine group.There are 90.88%（1215/1337） synthetic drug abusers having at least one withdrawal symptom,they often appear drug craving,drowsiness,fatigue,weakness and difficulty in concentrating.Drug craving ranked first in ketamine- only group and ATS ＋ ketamine group,ranked 4th in ATS-only group,while drowsiness ranked 1st in ATS group.Conclusion：There are some differences in symptoms and withdrawal symptoms among ATS and kemamine abusers in China,we should carry out the relevant preventive measures,treatments and management according to their characteristics.