138名氯胺酮成瘾者成瘾过程和滥用危害调查  

CHARACTERISTICS OF ADDICTION PROCESS AND HARMFULNESS OF DRUG ABUSE AMONG 138 CHINESE KETAMINE DEPENDENT USERS

作　　者：王子云[1,2] 李炜修[2,3] 鲍彦平[2] 贾忠伟[2] 穆悦[2] 连智[2] 刘志民[2] 

机构地区：[1]贵州医科大学公共卫生学院,贵州550025 [2]北京大学中国药物依赖性研究所,北京100191 [3]北京大学公共卫生学院,北京100191

出　　处：《中国药物依赖性杂志》2016年第1期91-97,共7页Chinese Journal of Drug Dependence

基　　金：十二五国家科技支撑计划课题支持项目(2012BAI01B07)

摘　　要：目的:调查以氯胺酮为主要成分的K粉滥用者成瘾特征及其危害性。方法:在4省份采用方便样本募集138例氯胺酮成瘾者,自拟氯胺酮滥用调查问卷开展现场调查,问卷中采用了修订的四阶段成瘾模型以描述氯胺酮成瘾过程。结果:氯胺酮滥用者以男性、汉族为主,婚姻状况多为未婚状况。氯胺酮滥用者首次出现药物渴求和开始规律使用药物的时间中位数均为30.0 d;进入强迫性使用阶段的时间中位数为60.0 d。氯胺酮滥用者强迫性使用药物的原因主要为"心中总想着K粉"(91.3%);50.5%的氯胺酮滥用者因"不吸时出现明显的不适(难受)"而强迫性使用药物。规律使用阶段,使用氯胺酮后欣快感的强度(VAS)评分中位数为5.50(cm),药物渴求感VAS评分中位数为7.22(cm),欣快感VAS评分和药物渴求感强度的Spearman相关系数为0.478(P<0.001)。长期滥用氯胺酮后,滥用者中出现的疾病症状主要包括尿频、尿急、血尿等泌尿系统症状(53.6%)、胃痛、胃炎等胃部症状(48.6%)、慢性鼻炎(36.2%)、鼻出血(21.7%)、鼻中隔穿孔(5.1%);部分氯胺酮滥用者学习/工作情况、社交活动、家庭责任承担等受到影响,甚至出现攻击他人或暴力行为和违法行为。结论:氯胺酮可以产生药物依赖性,其精神依赖是强迫性使用药物的重要原因;氯胺酮滥用可造成滥用者泌尿、消化系统等损害。Objective： To investigate the addiction process and harm of ketamine abuse.Methods： We enrolled 138 regular ketamine users（ without self-report of heroin use） via a convenient sampling strategy in 4 provinces and conducted a cross-sectional survey with a self-designed questionnaire,in which we employed a modified four-stage model of drug addiction by Chein,et al.to describe the drug addiction process.Results： Most users were male,Han people and unmarried.Among 138 ketamine users,the median intervals from onset drug use to the first drug craving,regular use and compulsive use were 30.0,30.0 and 60.0 days,respectively; compulsive users mainly considered drug craving（ 91.3%） as their motivations for compulsive drug use and some selected uncomfortable symptoms（ 50.5%）.The median VAS scores of euphoria and drug craving in regular stage among ketamine users were 5.50 cm and 7.22 cm,and their spearman coefficient was 0.478（ P 〈0.001）.Some ketamine users reported urinary symptoms（ 53.6%）,gastric symptoms（ 48.6%）,chronic rhinitis（ 36.2%）,epistaxis（ 21.7%） and perforation of nasal septum（ 5.1%）.In addition,ketamine abusers reported worse performance in work and study,worse social functions,even violent behaviors and criminal behaviors.Conclusion： Ketamine has definite potential for drug dependence, and psychological dependence is the fundamental motivation for compulsive drug use.Ketamine abuse may not only result in health damages to drug users,but also pose a threat on family harmony,and social safety and stability.

关 键 词：氯胺酮 滥用 成瘾 

分 类 号：R946[医药卫生—药剂学]