Hobkirk Andréa L, Watt Melissa H, Myers Bronwyn, Skinner Donald, Meade Christina S
Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Duke Global Health Institute, 310 Trent Drive, 333 Trent Hall, Box 90519, Durham, NC 27708, USA.
Duke University, Duke Global Health Institute, 310 Trent Drive, Trent Hall, Room 330, Durham, NC 27708, USA.
Int J Drug Policy. 2016 Apr;30:99-106. doi: 10.1016/j.drugpo.2015.10.006. Epub 2015 Oct 28.
Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals' initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa.
In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes.
On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered "trendy", which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town.
The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the availability and perceived normality of methamphetamine use, and to provide young people opportunities for recreation. On an individual level, addressing mental health and misconceptions about the dangers and benefits of methamphetamine could ameliorate willingness for initiation. Potential points of intervention include mass media campaigns and school-based interventions to raise awareness of the physical and social impacts of methamphetamine, and structural interventions to create safer neighborhoods, provide opportunities for employment and recreation, and expand mental health services to improve emotional health and coping skills.
尽管低收入和中等收入国家中甲基苯丙胺的使用显著增加，但在这些环境中，对于促使个人开始使用甲基苯丙胺的因素，几乎没有实证研究。本研究的目的是定性研究南非与开始使用甲基苯丙胺相关的因素。
在南非开普敦，对30名现用甲基苯丙胺者（13名女性和17名男性）进行了深入访谈。访谈内容包括对开始使用甲基苯丙胺时周围情况的叙述性描述。访谈进行了录音、转录和翻译。对转录文本使用文档备忘录、数据展示矩阵和持续比较技术进行分析以确定主题。
参与者平均在21岁左右开始定期使用甲基苯丙胺，且已使用了七年。出现了与开始使用甲基苯丙胺相关的四个主要主题。甲基苯丙胺使用者和经销商的存在使得该药物对于初次使用者来说既方便又极易获取。甲基苯丙胺越来越受欢迎且被认为“时髦”，这造成了来自朋友，较少情况下是家庭成员的社会压力，促使人们开始使用。娱乐和就业机会的缺乏进一步助长了这种情况，这导致无聊以及对该药物传闻中的积极效果产生好奇。年轻人还通过加入帮派使用和分销甲基苯丙胺，试图在经济机会有限的贫困社区赚取收入。最后，参与者将开始使用甲基苯丙胺描述为应对开普敦地区高暴力和犯罪率所引发的累积压力和心理负担的一种方式。
研究结果凸显了在南非这样的低收入和中等收入国家中开始使用甲基苯丙胺的复杂性质。需要在社区层面进行干预，以解决甲基苯丙胺使用的可得性和被视为正常的情况，并为年轻人提供娱乐机会。在个人层面，解决心理健康问题以及对甲基苯丙胺危害和益处的误解可以改善开始使用的意愿。潜在的干预点包括大众媒体宣传活动和基于学校的干预措施，以提高对甲基苯丙胺身体和社会影响的认识，以及结构性干预措施，以创建更安全的社区、提供就业和娱乐机会，并扩大心理健康服务以改善情绪健康和应对技能。
