Tanibuchi Yuko, Matsumoto Toshihiko, Funada Daisuke, Shimane Takuya
Department of Psychiatry, Chiba Hospital, Funabashi, Chiba, Japan.
Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
Neuropsychopharmacol Rep. 2018 Dec;38(4):189-196. doi: 10.1002/npr2.12035. Epub 2018 Oct 19.
This study aimed to investigate the influence of tightened regulations on new psychoactive substances in patients with disorders related to these drugs in Japan.
We used a biennial nationwide survey on drug-related psychiatric disorders to examine why individuals who had previously used new psychoactive substances as their primary drug (the drug that had the greatest impact on their psychiatric symptoms) had switched to other drugs, how they had used drugs in the last 12 months and what type of drugs they were now using. We compared the clinical features of these individuals with patients who mainly used new psychoactive substances and had used these drugs at least once in the last 12 months.
A total of 2262 people were included, and 399 had used new psychoactive substances. Of those, 71 people had switched to another drug as primary drug, mostly stimulant drugs (35.2%), hypnotics and anxiolytics (15.5%), and cannabis (14.1%) and used these drugs during the previous 12 months. The majority, 53.3%, had switched "because new psychoactive substances were no longer available." In total, 25 people mainly used new psychoactive substances. The group that had changed drugs had more experience of using methamphetamine and were more likely to have abused other drugs before using new psychoactive substances. They had often switched to illegal or prescription drugs after regulations had been tightened.
The number of patients abusing new psychoactive substances decreased after drug regulations were tightened, but new psychoactive substances-related problems still exist. It is therefore not enough to tighten regulations. Drug dependence treatment and recovery support are also needed.
本研究旨在调查日本对新型精神活性物质实施更严格监管对与这些药物相关疾病患者的影响。
我们利用一项关于药物相关精神障碍的全国性两年一次调查，来探究为何此前将新型精神活性物质作为主要药物（对其精神症状影响最大的药物）的个体转而使用其他药物，他们在过去12个月里如何使用药物以及他们目前正在使用何种类型的药物。我们将这些个体的临床特征与主要使用新型精神活性物质且在过去12个月内至少使用过一次这些药物的患者进行了比较。
总共纳入了2262人，其中399人使用过新型精神活性物质。在这些人中，71人已转而将另一种药物作为主要药物，大多是兴奋剂类药物（35.2%）、催眠药和抗焦虑药（15.5%）以及大麻（14.1%），并在过去12个月内使用了这些药物。大多数人（53.3%）转而使用其他药物是“因为新型精神活性物质不再可得”。总共有25人主要使用新型精神活性物质。更换药物的这一组有更多使用甲基苯丙胺的经历，并且在使用新型精神活性物质之前更有可能滥用过其他药物。在监管收紧后，他们经常转而使用非法药物或处方药。
药物监管收紧后，滥用新型精神活性物质的患者数量有所下降，但与新型精神活性物质相关的问题仍然存在。因此，仅收紧监管是不够的。还需要药物依赖治疗和康复支持。
