上海市美沙酮维持治疗门诊就诊者毒品滥用及其影响因素  

Drug abuse and related factors among methadone maintenance treatment objects in Shanghai

作　　者：傅洁[1] 尹鹤峰 岳清[1] 庄鸣华[1] 宁镇[1] FU Jie;YIN He-feng;YUE Qing;ZHUANG Ming-hua;NING Zhen(Department of STI/AIDS Prevention and Control Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Occupational Health Test and Evaluation Center,Shanghai Pulmonary Hospital, Tongji University,Shanghai 200433,China)

机构地区：[1]上海市疾病预防控制中心性病艾滋病防治科,上海200336 [2]同济大学附属上海市肺科医院职业卫生检测与评价中心,上海200433

出　　处：《复旦学报（医学版）》2018年第6期817-822,共6页Fudan University Journal of Medical Sciences

基　　金：上海市卫计委科研课题(20154Y0091)~~

摘　　要：目的了解上海市美沙酮维持治疗(methadone maintenance treatment,MMT)门诊服药对象毒品使用情况,并分析其影响因素。方法采用横断面研究设计,在上海市14个MMT门诊选取1 960名符合条件的服药人员进行问卷调查,收集社会人口学、药物滥用行为、维持治疗情况等相关信息,并开展五合一尿液毒品[吗啡、甲基苯丙胺(冰毒)、大麻、亚甲基二氧基甲基苯丙胺(摇头丸)、氯胺酮(K粉)]检测。结果 1 960名调查对象平均年龄(49.3±8.7)岁,平均吸食毒品(19.0±6.0)年,23.3%既往吸食过新型毒品,7.1%过去1个月有报告发生过吸毒行为。尿液检测结果:吗啡阳性率9.1%,冰毒阳性率3.7%,K粉阳性率0.1%,摇头丸阳性率0.3%,大麻阳性率0.2%。Logistic多因素回归分析结果显示:拒绝使用朋友提供的新型毒品的对象其吗啡滥用(OR=0.23,95%CI:0.14～0.39)与新型毒品滥用(OR=0.08,95%CI:0.05～0.15)风险均较低;与吸毒朋友没有交往(OR=0.59,95%CI:0.40～0.87)、治疗期间未发生脱失(OR=0.44,95%CI:0.30～0.64)的MMT服药对象吗啡滥用的风险较低;家庭关系一般较关系良好(OR=2.40,95%CI:1.17～4.92)、每天服药剂量40～59 mL较0～39 mL的(OR=1.96,95%CI:1.05～3.65)服药对象滥用吗啡风险增加;与参加MMT治疗3年以下的服药对象相比,参加MMT4～6年的服药对象滥用吗啡风险(OR=0.51,95%CI:0.31～0.82)与滥用新型毒品风险(OR=0.41,95%CI:0.17～0.97)均较低。结论 MMT门诊服药人员中存在滥用吗啡和其他新型毒品的现象,与吸毒朋友交往情况、家人关系、脱失及维持治疗时间有关联。应针对关键影响因素,对MMT服药对象有针对性地开展宣传教育和行为干预,减少毒品滥用的发生。Objective To investigate the proportion of drug abuse of methadone maintenance treatment(MMT)objects and to identify its related factors. Methods A total of 1 960 MMT objects in 14 MMT clinics in Shanghai were recruited to participate in a cross-section study.Questionnaire including demographic information,drug abuse and MMT information were surveyed.Urine sample was collected to conduct multi-drug test as a biological marker to identify morphine,methamphetamine(crystal meth),marijuane,methylenedioxy methamphetamine(ecstasy),and ketamine(specieal K)abuse. Results The average age of the 1 960 objects was(49.3±8.7)years old.The average duration of drug abuse was(19.0±6.0)years.About 23.3% of all the objects selfreported they had used club drug before,and 7.1% had abused drug in the past one month.Urine test showed that among the 1 960 objects,9.1% had abused morphine,3.7% had abused methamphetamine,0.1% had abused ketamine,0.3% had abused ecstasy and 0.2% had abused marijuana.Multiple logistic regression analysis showed that group of negative attitude towards club drug offered by friends had lower risk of abusing morphine(OR=0.23,95%CI:0.14-0.39)and club drug(OR=0.08,95%CI:0.05-0.15).The group of no contacts with drug abuse companion(OR=0.59,95%CI:0.40-0.87)and not having dropped out during MMT(OR=0.44,95%CI:0.30-0.64)had lower risk of abusing morphine.Compared with group of having good relationship with family and having daily methadone dose of 0-39 mL,the group of having ordinary relationship with family(OR=2.40,95%CI:1.17-4.92)and having daily methadone dose of 40-59 mL(OR=1.96,95%CI:1.05-3.65)had higher risk of abusing morphine.Compared with group of attending MMT for less than3 years,the group of attending MMT for 4-6 years had lower risk of abusing morphine(OR=0.51,95%CI:0.31-0.82)and club drug(OR=0.41,95%CI:0.17-0.97). Conclusions Drug abuse of morphine and club drug were common during MMT clinics in Shanghai,and is related with the family,contacts with drug abuse companion,drop out during MMT,and years eu

关 键 词：美沙酮 维持治疗 毒品滥用 影响因素 

分 类 号：R181.3.5[医药卫生—流行病学]