Lankenau Stephen E, Clatts Michael C
University of Southern California, Keck School of Medicine, Department of Pediatrics, Los Angeles, California 90028, USA.
Subst Use Misuse. 2005;40(9-10):1381-97. doi: 10.1081/JA-200066936.
Polydrug use is an important public health issue since it has been linked to significant adverse health outcomes. Recently, club drugs, including ketamine and other drugs used in dance/rave scenes, have been identified as key substances in new types of polydrug using patterns. While seemingly a self-explanatory concept, "polydrug" use constitutes multiple drug using practices that may impact upon health risks. Ketamine, a club drug commonly administered intranasally among youth for its disassociative properties, has emerged as a drug increasingly prevalent among a new hidden population of injection drug users (IDUs). Using an ethno-epidemiological methodology, we interviewed 40 young (<25 years old) ketamine injectors in New York during 2000-2002 to describe the potential health risks associated with ketamine and polydrug use. Findings indicate that ketamine was typically injected or sniffed in the context of a polydrug using event. Marijuana, alcohol, PCP, and speed were among the most commonly used drugs during recent ketamine using events. Polydrug using events were often quite variable regarding the sequencing of drug use, the drug combinations consumed, the forms of the drug utilized, and the modes of administrating the drug combinations. Future research should be directed towards developing a more comprehensive description of the risks associated with combining ketamine with other drugs, such as drug overdoses, the transmission of bloodborne pathogens, such as HIV and HCV, the short- and long-term effects of drug combinations on cognitive functioning, and other unanticipated consequences associated with polydrug use.
多药合用是一个重要的公共卫生问题，因为它与严重的不良健康后果有关。最近，包括氯胺酮和其他在舞会/锐舞场景中使用的药物在内的俱乐部药物，已被确定为新型多药合用模式中的关键物质。虽然“多药合用”看似是一个无需解释的概念，但它构成了多种可能影响健康风险的用药行为。氯胺酮是一种在年轻人中常用的俱乐部药物，因其解离特性通常通过鼻内给药，已成为在新的隐蔽注射吸毒人群（IDU）中越来越普遍的一种药物。我们采用民族流行病学方法，在2000年至2002年期间采访了纽约40名年龄小于25岁的氯胺酮注射者，以描述与氯胺酮和多药合用相关的潜在健康风险。研究结果表明，氯胺酮通常在多药合用的情况下注射或吸食。大麻、酒精、苯环利定和甲基苯丙胺是最近氯胺酮使用期间最常用的药物。多药合用在用药顺序、所消费的药物组合、所使用药物的形式以及药物组合的给药方式等方面往往差异很大。未来的研究应致力于更全面地描述氯胺酮与其他药物合用相关的风险，如药物过量、艾滋病毒和丙型肝炎病毒等血源性病原体的传播、药物组合对认知功能的短期和长期影响，以及与多药合用相关的其他意外后果。
