Centre for Addiction and Mental Health, Toronto, ON, Canada. Russell
Drug Alcohol Depend. 2009 Dec 1;105(3):185-93. doi: 10.1016/j.drugalcdep.2009.06.024. Epub 2009 Aug 20.
In response to its domestic methamphetamine problems and an emerging international consensus that methamphetamine precursor and essential chemicals should be controlled, Canada regulated its import/export of ephedrine and pseudoephedrine (precursor chemicals) in January 2003, its domestic distribution of those chemicals in July 2003, and its import/export and manufacturing of essential chemicals (e.g., toluene) in January 2004. This study examines the regulations' impact on the problem of methamphetamine-related hospital admissions in Canada.
ARIMA-based intervention time-series analysis was used to assess impacts on monthly counts of Canada's methamphetamine-related acute-care hospital admissions (04/1996 to 03/2005). Cocaine-, heroin/opioid-, and alcohol-related hospital admissions were examined as quasi-control time-series.
No impact was found for the January 2003 regulation. The July 2003 and January 2004 regulations were associated with 20% and 21% increases, respectively, in methamphetamine-related admissions. No impacts on the quasi-control time-series were found.
This study indicates that Canada's regulations were not associated with reductions in methamphetamine-related hospital admissions. The January 2003 regulation's focus on imports/exports rather than domestic distribution may help explain its lack of impact. In contrast, the two other regulations had salient domestic foci--domestic precursor sales (July 2003) and domestic essential chemical manufacturing (January 2004). Both regulations, however, were associated with increases in admissions, rather than declines. Government reports indicate that a shift in methamphetamine production, from smaller-scale operators to more sophisticated crime organizations (groups better able to circumvent the regulations), occurred around the times of the regulations. Such a shift could increase supply and possibly admissions.
针对国内的甲基苯丙胺问题，以及国际社会逐渐达成的将甲基苯丙胺前体和关键化学品纳入管制的共识，加拿大于 2003 年 1 月管制了麻黄碱和伪麻黄碱（前体化学品）的进出口，2003 年 7 月管制了这些化学品的国内分销，2004 年 1 月管制了关键化学品（如甲苯）的进出口和制造。本研究旨在检验这些法规对加拿大与甲基苯丙胺相关的住院治疗问题的影响。
采用基于 ARIMA 的干预时间序列分析，评估 2004 年 1 月至 2005 年 3 月期间加拿大与甲基苯丙胺相关的急性护理住院治疗人数月度计数的变化。将可卡因、海洛因/阿片类药物和酒精相关的住院治疗作为准对照时间序列进行研究。
2003 年 1 月的法规未产生影响。2003 年 7 月和 2004 年 1 月的法规分别导致与甲基苯丙胺相关的住院治疗人数增加了 20%和 21%。准对照时间序列未发现任何影响。
本研究表明，加拿大的法规与甲基苯丙胺相关的住院治疗人数减少无关。2003 年 1 月的法规侧重于进出口而非国内分销，这可能有助于解释其缺乏影响的原因。相比之下，另外两项法规具有明显的国内重点——国内前体销售（2003 年 7 月）和国内关键化学品制造（2004 年 1 月）。然而，这两项法规均与住院人数的增加而非减少相关。政府报告表明，在法规出台前后，甲基苯丙胺的生产从规模较小的经营者转向更复杂的犯罪组织（更有能力规避法规的组织），这可能增加了供应并可能导致住院人数增加。
