[New psychoactive substances abuse among patients with access to methadone maintenance treatment in Jiangsu province: a case-control study].
[New psychoactive substances abuse among patients with access to methadone maintenance treatment in Jiangsu province: a case-control study].
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DOI：
10.3760/cma.j.issn.0254-6450.2018.05.016
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发表时间：
2018-05-10
影响因子：
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通讯作者：
Cao, X B
中科院分区：
文献类型：
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作者：
Cheng, Z;Chen, G H;Cao, X B
目的：探讨接受美沙酮维持治疗（MMT）的患者滥用新型精神活性物质的原因和相关因素。方法：采用完善的问卷和尿检收集MMT使用者的人口特征、MMT状况和药物滥用、家庭和社会支持等信息。采用1∶1匹配的病例对照研究，采用条件logistic回归模型识别新型精神活性物质滥用的相关因素。结果：共招募了212名（106对）接受MMT的患者，其中大多数为男性（78.3%，166/212）、已婚或同居者（48.6%，103/212）和失业者（63.2%，134/212）。服务对象的平均年龄为（45.1±7.2）岁。滥用新型精神活性物质的主要类型是苯二氮卓类（62.3%，66/106）和甲基苯丙胺（39.6%，42/106）。滥用多种新型精神活性物质的比例为8.5%（9/106）。多变量条件logistic回归分析结果表明，在过去6个月的MMT治疗期间使用阿片类药物可能会增加滥用新型精神活性物质（OR=3.25，95%CI：1.35-7.79）、苯二氮卓类（OR=3.25，95%CI：1.11-9.47）和甲基苯丙胺（OR=13.31，95%CI：1.35-7.79）和甲基苯丙胺（OR=13.31，95%CI： 1.12-158.01）。此外，9年多来MMT降低了新型精神活性物质（OR=0.03，95%CI：0.01-0.21）、苯二氮卓类（OR=0.02，95%CI：0.00-0.36）和甲基苯丙胺（OR=0.02，95%CI：0.00-0.69）滥用的风险。结论：新型精神活性物质滥用的减少可能与 MMT 治疗持续时间的延长有关。家人和朋友的不适当支持可能会增加 MMT 客户滥用新精神活性物质的风险，尤其是使用阿片类药物的客户。
Objective: To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT). Methods: A well-developed questionnaire and urine tests were used to collect information about demographic characteristics, condition of MMT and drug abuse, family and social support of MMT clients. A 1∶1 matched case-control study was conducted, and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse. Results: A total of 212 (106 pairs) clients receiving MMT were recruited, and most of them were males (78.3%, 166/212), married or cohabitant (48.6%, 103/212) and unemployed (63.2%, 134/212). The average age of the clients was (45.1±7.2) years. The main types of abused new psychoactive substances were benzodiazepine (62.3%, 66/106) and methamphetamine (39.6%, 42/106). The proportion of abusing multi new psychoactive substances was 8.5% (9/106). Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25, 95%CI: 1.35-7.79), benzodiazepine (OR=3.25, 95%CI: 1.11- 9.47) and methamphetamine (OR=13.31, 95%CI: 1.12-158.01). Moreover, MMT for more than9 years reduced the risk of abuse of new psychoactive substances (OR=0.03, 95%CI: 0.01-0.21), benzodiazepine (OR=0.02, 95%CI: 0.00-0.36) and methamphetamine (OR=0.02, 95%CI: 0.00-0.69). Conclusion: Less new psychoactive substances abuse might be associated with longer duration of MMT treatment. And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients, especially in clients who used opioid.