云南省部分地区注射吸毒者海洛因过量情况及影响因素分析

周洋; 罗巍; 曹晓斌; 张波; 吴尊友

Abstract

周洋,罗巍,曹晓斌,张波,吴尊友.云南省部分地区注射吸毒者海洛因过量情况及影响因素分析[J].Chinese journal of Epidemiology,2016,37(5):648-652

云南省部分地区注射吸毒者海洛因过量情况及影响因素分析

Overdose of heroin and influencing factors in intravenous drug users in parts of Yunnan

Received:December 23, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.05.012

KeyWord: 注射吸毒者美沙酮维持治疗吸毒过量

English Key Word: Intravenous drug user Methadone maintenance treatment Overdose of heroin

FundProject:国家科技重大专项(2012ZX10001007002);中国艾滋病/结核病多学科研究培训项目(5U2RTW006918)

Author Name	Affiliation	E-mail
Zhou Yang	School of Public Health, Anhui Medical University, Hefei 230032, China National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Luo Wei	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Cao Xiaobin	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhang Bo	Social Science Section, Yunnan Institute for Drug Abuse, Kunming 650034, China
Wu Zunyou	School of Public Health, Anhui Medical University, Hefei 230032, China	wuzy@263.net

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Abstract:

目的了解云南省部分地区注射吸毒者(IDU)海洛因过量情况及其影响因素。方法采用横断面调查的方法,于2015年7-8月对云南省红河州和德宏州的4个美沙酮维持治疗(MMT)门诊和2个州强制戒毒所的IDU进行问卷调查,内容包括社会人口学特征、毒品使用情况、过去1年海洛因过量情况以及最近1次海洛因过量情况等。对过去1年发生过海洛因过量的相关因素进行logistic回归分析。结果共340名IDU符合入选标准,男性占85.3%(290/340),年龄为(37.7±8.7)岁,汉族占65.6%(223/340),HIV阳性检出率为49.4%(167/338),过去6个月使用过新型毒品占22.6%(77/340)。自吸毒以来,曾有过海洛因过量的比例为41.8%(142/340),海洛因过量次数M=3次。在过去1年中海洛因过量发生率为15.6%(53/340),M=1次。发生海洛因过量的年龄为(36.7±8.4)岁,吸毒年限为(16.5±7.6)年,男性占83.0%(44/53)。发生海洛因过量的主要原因为增加海洛因用量(26.4%,14/53)和多药滥用(28.3%,15/53)。非条件logistic回归模型分析显示:过去1年参加过MMT(OR=0.534,95%CI:0.290~0.980)可降低海洛因过量的风险,而过去6个月共用针具(OR=2.735,95%CI:1.383~5.407)和刚出戒毒所不满1年(OR=2.881,95%CI:1.226~6.767)会增加海洛因过量的风险。结论云南省IDU过去1年海洛因过量发生率较高。需要持续促进该地IDU参加MMT并加强预防和应对吸毒过量宣传教育,特别是对戒毒所吸毒人员出所前的宣传教育,同时应建立针对吸毒人员的戒毒所与MMT门诊转介机制。

English Abstract:

Objective To assess the prevalence of overdose of heroin and risk factors in intravenous drug users (IDUs) in Yunnan Province. Methods During July-August of 2015, IDUs were recruited from four methadone maintenance treatment (MMT) clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures, Yunnan province. The information about IDUs'demographic characteristics and drug use history, overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey. The factors associated with overdose of heroin were evaluated with logistic regression models. Results Of the 340 IDUs surveyed, 85.3%(290/340) were males, the mean age was 37.7±8.7 years, 65.6% (223/340) were Han ethnicity, and 49.4% (167/338) were HIV positive, 22.6%(77/340) reported having used club-related drugs (such as ephedrine, methamphetamine, benzodiazepines and ketamine) in the previous 12 months. Of the 340 IDUs, 41.8% (142/340) had at least one overdose of heroin in their lifetime (median:3 overdoses) and 15.6% (53/340) had at least one overdose of heroin (median:1 overdose use) in previous 12 months. The mean age of the 53 IDUs was (36.7±8.4) years, and 83.0% (44/53) of them were males, the average drug use history was (16.5±7.6) years. Dosage increase (26.4%, 14/53) and multidrug use (28.3%, 15/53) were the main causes for overdose of heroin. Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year (OR=0.534, 95%CI:0.290-0.980) was independently associated with decreased risk of overdose of heroin, needle sharing in the past 6 months (OR=2.735, 95%CI:1.383-5.407) and being forced to receive drug rehabilitation for less than one year (OR=2.881, 95%CI:1.226-6.767) were independently associated with increased risk of overdose of heroin. Conclusion Overdose of heroin is common among IDUs in Yunnan. It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin, especially before they leave drug rehabilitation centers. And it is important to establish a referral mechanism from drug rehabilitation center to MMT clinic for drug users.

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