Chai Yi, Luo Hao, Wei Yue, Chan Sherry K W, Man Kenneth K C, Yip Paul S F, Wong Ian C K, Chan Esther W
Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China.
Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong SAR, China.
Addiction. 2022 Jul;117(7):1940-1949. doi: 10.1111/add.15820. Epub 2022 Feb 15.
Drug use disorders are associated with increased risk of self-harm. Risk differences associated with specific types of drug use disorders are yet to be comprehensively reported. This study aimed to examine the risk of self-harm or suicide associated with different drug use disorders in Hong Kong.
Population-based cohort study.
The Clinical Data Analysis and Reporting System (CDARS) managed by the Hong Kong Hospital Authority.
Cases were people ages 10 years or older who visited a hospital Accident and Emergency department between 1 January, 2004 and 31 December, 2016 with any of 10 specific drug use disorders (comprising opioid; ketamine; methamphetamine; sedative, hypnotic, or anxiolytic; amphetamine or related stimulant; cocaine; cannabis; hallucinogen; unspecified or other drug; and polydrug). Each case was matched with two controls, selected from a subset of people in CDARS sharing the same gender, age and psychiatric profile. A total of 8270 cases and 16 540 matched controls were included.
Incidence and adjusted hazard ratio (aHR) of subsequent self-harm or suicide for each specific drug use disorder were estimated.
The most prevalent drug use disorder was opioid use disorder (2523; 30.51%) and the least prevalent was hallucinogen use disorder (77; 0.93%). The crude incidence of self-harm or suicide ranged from 26.57 (95% CI, 14.23-44.55) per 1000 person-years for cannabis use disorder to 91.97 (77.32-108.37) for polydrug use disorder. The highest risk of self-harm or suicide was observed in ketamine (aHR, 16.36; 95% CI, 11.03-24.29) and opioid (15.97; 10.73-23.23) use disorders.
In Hong Kong, all types of drug use disorders appear to be significantly associated with increased risk of self-harm or suicide, but risk levels vary by type of drug use disorder.
药物使用障碍与自伤风险增加相关。与特定类型药物使用障碍相关的风险差异尚未得到全面报道。本研究旨在探讨香港不同药物使用障碍与自伤或自杀风险的关系。
基于人群的队列研究。
香港医院管理局管理的临床数据分析与报告系统（CDARS）。
病例为2004年1月1日至2016年12月31日期间因10种特定药物使用障碍（包括阿片类药物；氯胺酮；甲基苯丙胺；镇静催眠药或抗焦虑药；苯丙胺或相关兴奋剂；可卡因；大麻；致幻剂；未指定或其他药物；以及多种药物）中的任何一种前往医院急诊科就诊的10岁及以上人群。每个病例与两名对照匹配，对照从CDARS中具有相同性别、年龄和精神状况的人群子集中选取。共纳入8270例病例和16540例匹配对照。
估计每种特定药物使用障碍后续自伤或自杀的发病率和调整后的风险比（aHR）。
最常见的药物使用障碍是阿片类药物使用障碍（2523例；30.51%），最不常见的是致幻剂使用障碍（77例；0.93%）。自伤或自杀的粗发病率从大麻使用障碍的每1000人年26.57（95%CI，14.23 - 44.55）到多种药物使用障碍的91.97（77.32 - 108.37）不等。氯胺酮（aHR，16.36；95%CI，11.03 - 24.29）和阿片类药物（15.97；10.73 - 23.23）使用障碍中观察到的自伤或自杀风险最高。
在香港，所有类型的药物使用障碍似乎都与自伤或自杀风险增加显著相关，但风险水平因药物使用障碍类型而异。
