Dhawan Anju, Pattanayak Raman Deep, Chopra Anita, Tikoo Vinod Kumar, Kumar Rajesh
National Drug Dependence Treatment Centre, New Delhi, India.
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Indian J Psychiatry. 2016 Oct-Dec;58(4):387-393. doi: 10.4103/0019-5545.196701.
Injection drug use (IDU) is intricately linked to preventive aspects for human immunodeficiency virus from a public health perspective. No large-scale data are yet available for injectable drug use among children and adolescents in India, apart from few anecdotal reports.
The present paper reports on the profile and substance use pattern of 509 child IDU users, among a total sample of over 4000 children using substances across 100 sites from 27 states and 2 UTs in India. It was undertaken in 2012-2013 by the National Commission of Protection for Child Rights in collaboration with the National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi. For inclusion, participants had to be 18 years or less, should have used at least one other substance besides tobacco in the last 1 year, and should be living at home/street, in or out of school. Data were gathered using a 95-item semi-structured questionnaire.
A large proportion of ever users of IDU also reported use in the past year (96.5%) and past month (92.7%). Apart from IDU, tobacco, alcohol, cannabis, and pharmaceutical opioids were the most common substances of abuse in order of frequency. There was an interval of about 3 years from the initiation of tobacco to the initiation of IDU. Average age of onset for IDU was a year lesser in males than female users. The street children initiated IDU earlier than out-of-school and schoolgoing children. No quit attempt was made by more than half of the children. More than 40% had frequent familial conflicts, more than half had a familial history of substance use, and three-fourths had drug-using peers.
The paper highlights the profile and pattern of children and adolescents using IDU across many parts of India, dispelling the myth that IDU is largely an adult phenomenon in India. There is a clear need to promote different harm reduction and preventive strategies across the "hard-to-reach" younger age groups using injecting drugs.
从公共卫生角度来看，注射吸毒与人类免疫缺陷病毒的预防方面有着复杂的联系。除了少数传闻报道外，印度儿童和青少年注射吸毒的大规模数据尚不可得。
本文报告了509名儿童注射吸毒者的概况和物质使用模式，这些儿童来自印度27个邦和2个联邦属地的100个地点、总数超过4000名使用物质的儿童样本。该研究于2012 - 2013年由国家儿童权利保护委员会与新德里全印度医学科学研究所国家药物依赖治疗中心合作开展。纳入的参与者年龄须在18岁及以下，在过去1年中除烟草外还须使用过至少一种其他物质，且须居住在家中/街头，无论是否在校。数据通过一份95项的半结构化问卷收集。
很大一部分曾经注射吸毒的人也报告在过去一年（96.5%）和过去一个月（92.7%）有过注射吸毒行为。除注射吸毒外，烟草、酒精、大麻和药用阿片类物质是按使用频率排序最常见的滥用物质。从开始使用烟草到开始注射吸毒的间隔约为3年。男性注射吸毒的平均起始年龄比女性使用者小一岁。街头儿童比校外儿童和在校儿童更早开始注射吸毒。超过一半的儿童没有尝试戒毒。超过40%的儿童经常与家人发生冲突，超过一半的儿童有物质使用的家族史，四分之三的儿童有吸毒的同龄人。
本文突出了印度许多地区儿童和青少年注射吸毒的概况和模式，消除了注射吸毒在印度主要是成年人现象的误解。显然有必要针对使用注射毒品的“难以接触到的”较年轻年龄组推广不同的减少伤害和预防策略。
