British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
Drug Alcohol Depend. 2013 Sep 1;132(1-2):251-6. doi: 10.1016/j.drugalcdep.2013.02.011. Epub 2013 Mar 13.
In recent years, the Thai government has strengthened drug law enforcement as a strategy to address a continuing epidemic of illicit drug use. We sought to assess temporal trends in street-level availability of illicit drugs among injection drug users (IDUs) in Bangkok, Thailand.
Using univariate statistics and multivariate logistic regression, we assessed changes in the availability of five substances (heroin, methamphetamine, crystal methamphetamine, midazolam, and illicit methadone) between 2009 and 2011 and examined social, structural and individual factors influencing availability among community-recruited samples of IDUs in Bangkok. Availability was measured in three levels: immediate (available in ≤10 min); moderate (available in 10-90 min); and delayed (available in >90 min; our reference category).
The analyses included 718 IDUs, including 165 (23.0%) women. Controlling for changes in participant characteristics between assessments, and in a period of constant nominal illicit drug prices, moderate availability of all substances increased significantly between 2009 and 2011, with adjusted odds ratios ranging between 2.36 (illicit methadone) and 4.61 (crystal methamphetamine) (all p<0.01). Immediate availability of all substances but heroin also increased (all p<0.01). More immediate availability of methamphetamine was also associated with a history of incarceration (p<0.05).
Despite the Thai government's intensified drug suppression efforts, the availability of illicit drugs among IDUs in Bangkok increased significantly between 2009 and 2011. The findings raise concern about the overreliance on drug law enforcement-based approaches and point to the need for greater investment in evidence-based drug policies.
近年来，泰国政府加强了禁毒执法力度，将其作为解决非法药物持续滥用这一问题的策略。我们试图评估泰国曼谷注射吸毒者（IDU）街头非法药物供应的时间趋势。
使用单变量统计和多变量逻辑回归，我们评估了 2009 年至 2011 年间五种物质（海洛因、甲基苯丙胺、冰毒、咪达唑仑和非法美沙酮）供应情况的变化，并检查了影响曼谷社区招募的 IDU 样本供应情况的社会、结构和个体因素。供应情况分为三个水平进行衡量：即时（可在 ≤10 分钟内获得）；中度（可在 10-90 分钟内获得）；延迟（可在 >90 分钟内获得；我们的参考类别）。
分析包括 718 名 IDU，其中 165 名（23.0%）为女性。在控制评估之间参与者特征的变化以及名义非法药物价格不变的情况下，所有物质的中度供应在 2009 年至 2011 年间均显著增加，调整后的优势比范围在 2.36（非法美沙酮）至 4.61（冰毒）之间（均 p<0.01）。所有物质的即时供应也有所增加（均 p<0.01），但海洛因除外。甲基苯丙胺的即时供应增加也与被监禁史有关（p<0.05）。
尽管泰国政府加强了禁毒努力，但曼谷 IDU 中非法药物的供应在 2009 年至 2011 年间显著增加。这些发现令人担忧，因为过度依赖禁毒执法手段，并指出需要对基于证据的毒品政策进行更大的投资。
