Specka Michael, Kuhlmann Thomas, Sawazki Jürgen, Bonnet Udo, Steinert Renate, Cybulska-Rycicki Monika, Eich Helmut, Zeiske Benita, Niedersteberg Antje, Schaaf Luzia, Scherbaum Norbert
LVR Hospital Essen Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
Psychosomatische Klinik Bergisch Gladbach, Bergisch Gladbach, Germany.
Front Psychiatry. 2020 Jul 7;11:569. doi: 10.3389/fpsyt.2020.00569. eCollection 2020.
About 15 years ago, a diverse group of new recreational psychotropic substances began to emerge, which were marketed for example as "legal highs," "research chemicals," or "designer drugs." These substances were later subsumed under the label "Novel Psychoactive Substances" (NPS). Important NPS classes are cathinones, synthetic cannabimimetics, phenethylamines, and herbal drugs. The health care system for psychotropic substance use disorders (SUDs) traditionally focused on a few substances, such as alcohol, heroin, cocaine, amphetamines, or cannabis. Users of illicit substances often engage in polydrug use. However little is known about the prevalence of NPS use within the group of "classical" illicit substance users.
We investigated lifetime and recent use of NPS and other drugs in patients who underwent in-patient detoxification treatment from illicit drugs in Germany.
In a multicenter study with eight participating facilities, patients admitted to treatment underwent a standardized interview at admission, concerning their past and current substance use. The interview comprised classical substances of abuse, NPS, and rarely used substances such as LSD. In addition, participating sites had the opportunity to analyze their patients' routine drug screenings by means of gas chromatography/mass spectrometry (GC/MS), which permitted detection of NPS.
Interviews from 295 patients could be analyzed. Most patients were opiate dependent and multiple substance users. About 32% reported use of synthetic cannabimimetics during lifetime, but usually only a few times. An important reason for their use was that NPS were not detected by drug testing in prisons or drug treatment facilities. Cathinones, herbal drugs or other NPS had rarely been used during lifetime. NPS use during the last 30 days before admission was nearly zero. This was confirmed by urine analysis results. In contrast, lifetime and current use of opiates, alcohol, cocaine, benzodiazepines, and cannabis was high. In addition, 18% reported of regular unprescribed pregabalin use during lifetime, and 20% had recently used pregabalin.
Patients admitted to drug detoxification treatment showed multiple substance use, but this did not include NPS use. The diversion of legal medications such as pregabalin in this group is a serious concern.
大约15年前，各种各样新型的消遣性精神活性物质开始出现，它们被作为“合法兴奋剂”“研究化学品”或“ designer drugs”进行销售。这些物质后来被归入“新型精神活性物质”（NPS）类别。重要的NPS类别包括卡西酮、合成大麻素、苯乙胺和草药类药物。传统上，精神活性物质使用障碍（SUDs）的医疗保健系统主要关注少数几种物质，如酒精、海洛因、可卡因、苯丙胺或大麻。非法物质使用者常常同时使用多种药物。然而，对于“经典”非法物质使用者群体中NPS的使用流行情况知之甚少。
我们调查了在德国接受非法药物住院戒毒治疗的患者中NPS及其他药物的终生使用情况和近期使用情况。
在一项有八个参与机构的多中心研究中，入院接受治疗的患者在入院时接受了关于其过去和当前物质使用情况的标准化访谈。访谈内容包括经典滥用物质、NPS以及诸如麦角酸二乙酰胺（LSD）等很少使用的物质。此外，参与机构有机会通过气相色谱/质谱联用仪（GC/MS）分析其患者的常规药物筛查结果，这能够检测出NPS。
对295名患者的访谈结果进行了分析。大多数患者对阿片类药物有依赖且使用多种物质。约32%的患者报告终生使用过合成大麻素，但通常仅使用过几次。他们使用合成大麻素的一个重要原因是监狱或戒毒治疗机构的药物检测未检测出NPS。卡西酮、草药类药物或其他NPS的终生使用情况很少。入院前最后30天内NPS的使用几乎为零。尿液分析结果证实了这一点。相比之下，阿片类药物、酒精、可卡因、苯二氮卓类药物和大麻的终生使用和当前使用情况较为普遍。此外，18%的患者报告终生经常非处方使用普瑞巴林，20%的患者最近使用过普瑞巴林。
入院接受药物戒毒治疗的患者存在多种物质使用情况，但不包括NPS的使用。该群体中普瑞巴林等合法药物的滥用是一个严重问题。
