台湾新刑罚体系下娱乐性氯胺酮初次使用者：2009 年至 2017 年全国队列的发生率、累犯和死亡率。

First-time offenders for recreational ketamine use under a new penalty system in Taiwan: incidence, recidivism and mortality in national cohorts from 2009 to 2017.

机构信息

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.

出版信息

Addiction. 2021 Jul;116(7):1770-1781. doi: 10.1111/add.15337. Epub 2020 Dec 20.

DOI:10.1111/add.15337

PMID:33197101

Abstract

BACKGROUND AND AIMS

Ketamine has become a new recreational drug of choice among young people in parts of Asia. Using national databases in Taiwan, this study aimed to (1) examine the yearly trend in the ketamine offence rate over time; (2) estimate the 3-year risk of drug-related re-offence and its correlates among the first-time offenders; and (3) estimate the 3-year standardized mortality ratio (SMR) among the first-time offenders.

DESIGN, SETTING AND PARTICIPANTS: Retrospective cohort studies of offenders for recreational ketamine use in a penalty system initiated in 2009. Offenders for recreational ketamine use were identified from the Administrative Penalty System for Schedule III/IV Substances database from 2009 to 2017, and the re-offence rate and mortality among first-time offenders were assessed via record-linkage within the database as well as with both the criminal drug offence database and the national mortality database. The cohort from 2009 to 2016 (n = 39 178) was used for the recidivism analysis and the cohort from 2009 to 2013 (n = 25 357) was used for the 3-year SMR analysis.

MEASUREMENTS

Recidivism was estimated using survival analysis of the event as re-arrest for using ketamine, more serious illicit drugs (Schedules I/II), or any illicit drugs (ketamine or Schedules I/II). SMRs were estimated for overall and cause-specific death within 3 years after the first offence for ketamine use.

FINDINGS

The age-standardized rates for both prevalent (1.38 per 1000) and first-time offenders (0.65 per 1000) peaked in 2013 and then decreased steadily. The 3-year risk of re-offence was 33.85% [95% confidence interval (CI) = 33.23-34.47%) for ketamine use and 39.52% (95% CI = 39.00-40.04%) for any illicit drug use. These first-time offenders had an SMR of 4.9 (95% CI = 4.3-5.4) for overall mortality, 2.1 (95% CI = 1.6-2.7) for natural deaths and 7.6 (95% CI = 6.7-8.6) for unnatural deaths.

CONCLUSIONS

Recreational ketamine use in Taiwan appears to lead not only to high risk for drug-related re-offence but also to excess mortality.

摘要

背景与目的

在亚洲部分地区，氯胺酮已成为年轻人新的消遣性毒品。本研究利用台湾的国家数据库，旨在：（1）考察氯胺酮犯罪率随时间的年度趋势；（2）估算首次犯罪者中与毒品相关的复犯风险及其相关因素；（3）估算首次犯罪者的 3 年标准化死亡率（SMR）。

设计、设置和参与者：2009 年启动的刑罚制度中消遣性氯胺酮使用者的回顾性队列研究。从 2009 年至 2017 年，从行政处罚制度附表 III/IV 物质数据库中确定消遣性氯胺酮使用者的罪犯，并通过数据库内的记录链接以及刑事毒品犯罪数据库和国家死亡率数据库来评估首次犯罪者的复犯率和死亡率。2009 年至 2016 年的队列（n=39178）用于复发分析，2009 年至 2013 年的队列（n=25357）用于 3 年 SMR 分析。

测量

使用首次氯胺酮再逮捕或更严重非法药物（I/II 类）或任何非法药物（氯胺酮或 I/II 类）的事件作为生存分析来估计复发率。在首次使用氯胺酮后 3 年内，估算总体和特定原因的 SMR。

结果

流行率（1.38 例/1000）和首次犯罪者（0.65 例/1000）的年龄标准化率在 2013 年达到峰值，然后稳步下降。氯胺酮使用的 3 年再犯风险为 33.85%[95%置信区间（CI）=33.23-34.47%]，任何非法药物使用的 3 年再犯风险为 39.52%（95%CI=39.00-40.04%）。这些首次犯罪者的总死亡率为 SMR 4.9（95%CI=4.3-5.4），自然死亡率为 2.1（95%CI=1.6-2.7），非自然死亡率为 7.6（95%CI=6.7-8.6）。