Chen Chuan-Yu, Storr Carla L, Anthony James C
National Health Research Institutes, Division of Mental Health and Substance Abuse Research, 35 Keyan Road, Zhunan, Miaoli County 350, Taiwan.
Addict Behav. 2009 Mar;34(3):319-22. doi: 10.1016/j.addbeh.2008.10.021. Epub 2008 Nov 1.
There is substantial evidence that alcohol, tobacco, and cannabis dependence problems surface more quickly when use of these drugs starts before adulthood, but the evidence based on other internationally regulated drugs (e.g., cocaine) is meager. With focus on an interval of up to 24 months following first drug use, we examine drug-specific and age-specific variation in profiles of early-emerging clinical features associated with drug dependence. Based upon the United States National Surveys on Drug Use and Health (NSDUH) conducted in 2000-2002, the risk of experiencing drug dependence problems was robustly greater for adolescent recent-onset users of cocaine, psychostimulant drugs other than cocaine, analgesics, anxiolytic medicines, inhalants drugs, and cannabis, as compared to adult recent-onset users (odds ratio=1.5-4.3, p<0.05). This was not the case for the NSDUH hallucinogens group (e.g., LSD). The adolescent onset associated excess risk was not constant across all clinical features. Our evidence suggests promoting earlier detection and interventions, as well as greater parent and peer awareness of drug dependence clinical features that may develop early among young people who have just started using drugs.
有大量证据表明，若在成年前开始使用酒精、烟草和大麻，对这些药物的依赖问题会更快出现，但基于其他国际管制药物（如可卡因）的证据却很少。我们聚焦首次使用药物后长达24个月的时间段，研究与药物依赖相关的早期出现的临床特征在药物种类和年龄方面的差异。根据2000 - 2002年美国全国药物使用和健康调查（NSDUH），与成年近期开始使用药物者相比，青少年近期开始使用可卡因、除可卡因外的精神刺激药物、镇痛药、抗焦虑药、吸入剂药物和大麻的使用者出现药物依赖问题的风险显著更高（优势比 = 1.5 - 4.3，p < 0.05）。NSDUH中的致幻剂组（如麦角酸二乙酰胺）情况并非如此。青少年开始使用药物所带来的额外风险在所有临床特征中并非一成不变。我们的证据表明应促进更早的检测和干预，以及提高家长和同龄人对刚开始使用药物的年轻人中可能早期出现的药物依赖临床特征的认识。
