Rácz József, Csák Róbert, Faragó Renáta, Vadász Viktória
ELTE Pedagogiai es Pszichologiai Kar, Pszichologiai Intezet, Budapest, Hungary.
Psychiatr Hung. 2012;27(1):29-47.
Important part of the studies on drug use deals with drug use transitions because of their public health consequences. Narrating of drug use change states the active decision making in the centre of the process with adding mental states of the participants to the change process. The transitional narratives can be embedded in the social context of "risk environment".
In the micro-segregation of the Middle-Jozsefvaros (8th district, Budapest) the Blue Point Foundation runs a needle-exchange service in its "Contact Programme". Here the number of registered clients was 2066 in 2010. The study participants were recruited from the clients of this needle-exchange service (from December 2010 to February 2011). The criterion of entering the study sample was injecting mephedrone in the past 30 days. 17 participants were interviewed. The life story interviews had been coded thematically; it had been done until new codes did not carry new meanings.
Study participants speak about rapid tolerance and more intensive use of mephedrone after changing their usual drug. This use is more risky because of more frequent injecting. The effect of mephedrone was described like 3,4- Methylenedioxymethamphetamine (MDMA) and cocaine. In the interviews the usual pattern was narrating the positive effects of mephedrone and after this text the narrating of the negative effects. The "risk narrative" and the "enjoyment narrative" were presented separately in the interviews.
Not the expansion of the drug market, but the drug change was observed: earlier drugs to mephedrone or parallel use of mephedrone with earlier drugs (amphetamine and heroin). The purity and availability of heroin and the increase availability of mephedrone may take a role in this process. The absent of drug market expansion was explained by the closeness of the micro-segregation. Results raise attention of the public health consequences of drug change and the proper training of professionals for this change.
由于药物使用转变对公共卫生有影响，因此药物使用研究的重要部分涉及药物使用转变。药物使用变化的叙述表明，在这一过程的核心是积极的决策过程，同时将参与者的心理状态纳入变化过程。过渡性叙述可以嵌入“风险环境”的社会背景中。
在布达佩斯第八区的中约瑟夫瓦罗斯的微观隔离区，蓝点基金会在其“接触计划”中开展了针头交换服务。2010年，这里登记的客户有2066人。研究参与者从该针头交换服务的客户中招募（2010年12月至2011年2月）。进入研究样本的标准是在过去30天内注射过甲麻黄碱。对17名参与者进行了访谈。对生活故事访谈进行了主题编码；一直进行到新代码不再有新含义为止。
研究参与者表示，在改变常用药物后，对甲麻黄碱的耐受性迅速增加，使用强度也更大。由于注射频率更高，这种使用方式风险更大。甲麻黄碱的效果被描述为类似于3,4-亚甲基二氧甲基苯丙胺（摇头丸）和可卡因。在访谈中，常见的模式是先叙述甲麻黄碱的积极作用，然后再叙述其消极作用。“风险叙述”和“享受叙述”在访谈中分别呈现。
观察到的不是毒品市场的扩张，而是毒品的变化：从早期毒品转向甲麻黄碱，或甲麻黄碱与早期毒品（苯丙胺和海洛因）同时使用。海洛因的纯度和可获得性以及甲麻黄碱可获得性的增加可能在这一过程中起作用。微观隔离区的封闭性解释了毒品市场没有扩张的原因。研究结果引起了人们对毒品变化对公共卫生影响的关注，以及专业人员针对这种变化进行适当培训的关注。
