氯胺酮的成瘾性特征及其相关因素分析

INVESTIGATION FOR PREVALENCE OF KETAMINE DEPENDENCE AND ITS ASSOCIATED FACTORS

目的:了解我国氯胺酮使用人群的基本特征,以及该人群氯胺酮的成瘾情况及其影响因素。方法:采用自拟调查问卷,从2013年1月至2015年12月,对北京、上海、云南、湖南和广东深圳等省市的强制隔离戒毒机构中有过合成毒品使用经历的人群进行横断面调查,并对其中目前主要使用氯胺酮的调查对象进行分析。结果:本次调查共纳入333名氯胺酮使用者,主要来自深圳(60.1%)和湖南(30.0%),平均年龄为27岁,以男性(84.5%)、汉族(92.4%)、未婚(66.7%)和初中及以下文化程度者(70.3%)居多。吸毒原因主要是受朋友或同伴影响(51.8%),消遣或追求刺激(33.0%)等。氯胺酮的使用场所主要是歌舞厅/迪厅等娱乐场所(69.4%)。吸毒方式以鼻吸(75.9%)和烫吸(19.3%)为主,13.5%的人有注射使用毒品史。每天都使用氯胺酮者占21.6%,43.8%的调查对象有多药滥用经历。根据DSM-IV诊断标准,有52.3%的调查对象符合氯胺酮成瘾特征。以是否有氯胺酮成瘾为因变量进行因素分析,多因素logistic回归分析显示男性(OR=3.76,95%CI 1.53-9.25)、累计使用时间更长(24~60个月:OR=2.74,95%CI 1.29-5.83;≥60个月:OR=4.24,95%CI 1.45-12.35)、每天使用氯胺酮(OR=5.83,95%CI 2.38-14.29)、滥用过酒类(OR=2.09,95%CI 1.11-3.92)和注射使用毒品史(OR=3.84,95%CI 1.50-9.81)会增加氯胺酮成瘾风险,是氯胺酮成瘾的独立危险因素。结论:本调查发现,在强制隔离戒毒机构的氯胺酮使用者中,有一半以上符合氯胺酮成瘾标准。提示氯胺酮成瘾性较强,我国需采取综合干预措施预防氯胺酮的滥用及成瘾,并应及时建立氯胺酮成瘾的规范诊疗体系,减少其健康及公共卫生危害。

Objective： To explore the basic characteristics of ketamine users in China,and to access the prevalence of ketamine dependence and its associated factors.Methods： A cross-sectional study was conducted among individuals who have used synthetic drugs in compulsory detoxification centers in Beijing,Shanghai,Yunnan,Hunan and Shenzhen from January 2013 to December 2015. We investigated the demographic characteristics,profiles of ketamine use,and dependence symptoms among synthetic drug users by a self-designed questionnaire. Subjects who mainly used ketamine were included in this analysis.Results： Total 333 ketamine users were analysed. They were mainly from Shenzhen （ 60. 1%） and Hunan（ 30. 0%）. The mean age was 27 years old. They were mainly male（ 84. 5%）,Han people（ 92. 4%） and unmarried（ 66. 7%）. The education level of the ketamine user was low,with70. 3% from junior high school or less. Main reasons for ketamine use were influenced of friends or peers（ 51. 8%） and pursuit of stimulation or recreation（ 33. 0%）. Ketamine was mainly used in dance hall and other entertainment venues（ 69. 4%） by snorting（ 75. 9%） and smoking（ 19. 3%）. And 13. 5%ketamine users had a history of drug injection. 21. 6% subjects reported daily use of ketamine. About43. 8% participants had experienced polydrug use. According to DSM-IV criteria,52. 3% participants reported that they were dependent on ketamine. Multiple logistic regression analysis showed that being male（ OR = 3. 76,95% CI 1. 53-9. 25）,longer duration of ketamine use（ 24 ~ 60 ms： OR = 2. 74,95% CI 1. 29-5. 83; ≥60 ms： OR = 4. 24,95% CI 1. 45-12. 35）,daily use of ketamine（ OR =5. 83,95% CI 2. 38-14. 29）,history of alcohol drinking（ OR = 2. 09,95% CI 1. 11-3. 92） and drug injection history（ OR = 3. 84,95% CI 1. 50-9. 81） were the risk factors of ketamine dependence.Conclusion： Ketamine has a high dependence potential,and more efforts should be made to establish a normative treatment system when planning interventions and policies in terms of ketamine abuse prevention.