Department of Clinical Psychology, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Subst Abuse Treat Prev Policy. 2017 Nov 2;12(1):47. doi: 10.1186/s13011-017-0132-3.
Substance use disorders along with neuropsychiatric disorders contributed about 14% of the global burden of disease. Harmful alcohol use, is a known contributor for many harms (accidents, suicide, violence, and complication of other psychiatric and medical disorders). In the Western countries, alcohol and nicotine are gateway drugs to cannabis use, and cannabis use is a risk factor for other illicit drugs such as cocaine and heroin. Khat use is another psychoactive substance which is common in East African and Arabian Peninsula. But there is a knowledge gap regarding the position of khat use or problematic khat use in sequential progression of different psychoactive substances. Therefore, we aimed to understand and investigate the relationship of problematic khat use and other psychoactive substances in Ethiopia.
Exploratory mixed methods study was employed. Quantitative cross sectional survey was done among 102 khat users, and 4 focus group discussions and 11 in-depth interviews were conducted to understand the pathways between khat use and other psychoactive substances use in 2014. Non random sampling (purposive and snowballing) was employed for both quantitative and qualitative studies. Khat users from khat cafeterias, shops, and from other open markets of khat in Addis Ababa were invited to participate.
Currently significant majorities of khat users (86.3%) used at least one other psychoactive substance after they started khat use. The prevalence of harmful drinking was 53.9% among khat users. Problematic khat use was a significant predictor of harmful drinking (p < 0.05). About one from ten respondents engaged to risky sexual behavior pushed by the effect of khat after chewing.
The proportion of psychoactive substances use especially harmful drinking among khat users was observed higher compared to other cross sectional surveys conducted among general population. In Ethiopia, intervention and policy on harmful alcohol use could consider problematic khat use as one possible risky factor. A rigorous methodology which could test gateway hypothesis of problematic psychoactive substances use could be warranted.
物质使用障碍和神经精神障碍导致了全球疾病负担的 14%左右。有害饮酒是许多危害（事故、自杀、暴力和其他精神和医学疾病并发症）的已知原因。在西方国家，酒精和尼古丁是大麻使用的门户药物，而大麻使用是可卡因和海洛因等其他非法药物使用的危险因素。阿拉伯茶是另一种常见于东非和阿拉伯半岛的精神活性物质。但是，关于阿拉伯茶使用或有问题的阿拉伯茶使用在不同精神活性物质的连续进展中的位置，存在知识差距。因此，我们旨在了解和调查埃塞俄比亚有问题的阿拉伯茶使用与其他精神活性物质之间的关系。
采用探索性混合方法研究。对 102 名阿拉伯茶使用者进行了横断面调查，在 2014 年进行了 4 次焦点小组讨论和 11 次深入访谈，以了解阿拉伯茶使用与其他精神活性物质使用之间的关系。定量和定性研究均采用非随机抽样（目的抽样和滚雪球抽样）。邀请来自亚的斯亚贝巴的阿拉伯茶咖啡馆、商店和其他阿拉伯茶开放市场的阿拉伯茶使用者参加。
目前，大多数阿拉伯茶使用者（86.3%）在开始使用阿拉伯茶后至少使用了一种其他精神活性物质。阿拉伯茶使用者中有害饮酒的患病率为 53.9%。有问题的阿拉伯茶使用是有害饮酒的显著预测因素（p<0.05）。大约十分之一的受访者在咀嚼阿拉伯茶后受到影响而从事危险的性行为。
与在一般人群中进行的其他横断面调查相比，观察到阿拉伯茶使用者使用精神活性物质，特别是有害饮酒的比例较高。在埃塞俄比亚，针对有害饮酒的干预和政策可以将有问题的阿拉伯茶使用视为一个可能的危险因素。需要一种严格的方法来检验有问题的精神活性物质使用的门户假说。
