广东省中山市盐酸美沙酮服药人员用药情况分析

Medication Situation of the Methadone Hydrochloride Drug Takers in Zhongshan City of Guangdong Province

目的为提高盐酸美沙酮用于戒毒者维持治疗的服药效果提供参考。方法以中山市第二人民医院南区分院药物维持治疗门诊、4个延伸点及中山市第三人民医院美沙酮门诊接受盐酸美沙酮维持治疗的部分服药人员为研究对象,分析其用药情况。结果481名研究对象中,男434名,女47名;年龄多集中在18~60岁(98.54%);学历多为小学、初中(70.27%),无业人员占48.23%;经济多一般或较差(82.12%);一直或基本坚持服药的占63.41%;合并疾病为艾滋病和丙型肝炎;能完全按要求坚持盐酸美沙酮治疗的有78名(37.01%);最近1年除使用盐酸美沙酮外还滥用过1种或多种药物(毒品)的有303名(62.99%),滥用频率最高的为海洛因(31.31%),其次为去痛片(17.17%)、地西泮(12.12%)、曲马多(10.10%)等;研究对象的盐酸美沙酮用量较分散,个体差异明显,平均用量为每次76.30 m L;维持治疗期间主要药品不良反应为便秘(42.20%)、嗜睡(18.50%)、恶心呕吐(15.80%)等。结论研究对象90%为男性,多处于无业状态,相对经济状况较差,大多能完全按要求接受药物治疗,虽然对毒品的认知微弱,但其行为改变的动机较强。作为药师,应在用药全过程中加强用药监护,关注药品不良反应,制订个体化给药方案,与医护人员、社会工作人员、服药人员自身及其家属共同探讨,制订合理的减量计划,帮助服药人员顺利完成脱毒治疗阶段,降低其脱失率,从而减少其违规违纪现象。

Objective To provide a reference for improving the effect of methadone hydrochloride in maintenance treatment of drug addicts.Methods Some of the drug addicts who received methadone hydrochloride maintenance treatment in the South District Branch of Zhongshan Second People’s Hospital,the four extension points and the Methadone Clinic of Zhongshan Third People’s Hospital were selected,and their medication situation was analyzed.Results Among 481 drug addicts,434 males and 47 females,and the age was mainly 18-60 years old(98.54%),the education level was mostly primary school and junior high school(70.27%),and unemployed people accounted for 48.23%,their economy was general and poor(82.12%),63.41%of them had been or basically insisted on taking drugs,and their combined diseases were acquired immune deficiency syndrome(AIDS)and hepatitis C.A total of 78 patients(37.01%)could insist on the treatment of methadone hydrochloride completely according to the requirements.In recent one year,303(62.99%)of them had abused one or more drugs(narcotics)except for methadone hydrochloride.Heroin(31.31%)was the most frequently abused drug,followed by Qutong Tablets(17.17%),diazepam(12.12%)and tramadol(10.10%).The dosage of methadone hydrochloride was dispersive in the drug addicts and the individual difference of the drug addicts was obvious with the average dosage of76.30 m L each time.The main adverse drug reactions during maintenance treatment were constipation(42.20%),drowsiness(18.50%),nausea and vomiting(15.80%).Conclusion Nearly 90%of the subjects are male,most of them are unemployed,and their economic status is relatively poor.Most of them can completely follow the drug treatment according to the requirements.Although they were less cognizance of the narcotics problem,their motivation to change their behavior was stronge.As pharmactists,we should strengthen drug monitoring during the whole process of drug use,pay attention to adverse drug reactions,make individualized drug delivery plan,discuss with medical staff,social workers,drug takers and their family members to formulate a reasonable reduction plan,help drug takers to successfully complete the detoxification treatment,reduce their loss rate,and reduce their illegal and disciplinary behaviors.