U1106 Aix-Marseille Université, Inserm, Marseille, France.
Centre d'évaluation et d'information sur la pharmacodépendance - Addictovigilance, Service de pharmacologie clinique, Assistance Publique - Hôpitaux de Marseille, Marseille, France.
Fundam Clin Pharmacol. 2024 Oct;38(5):978-987. doi: 10.1111/fcp.12995. Epub 2024 Feb 19.
Due to its psychoactive effects, ketamine has become a drug used for non-medical purpose.
To assess the latest trends in ketamine use among people with substance use disorder and to characterize its clinical complications using complementary health data sources of the French Addictovigilance Network.
First, we extracted all reports involving ketamine from 2012 to 2021 from the database of the OPPIDUM program (i.e., a multicentric program conducted in collaboration with hundreds of substance abuse treatment facilities that collects data on drugs used by subjects with substance use disorders). We described the reports globally and the changes from 2012 to 2021. Second, we extracted all cases involving ketamine from July 2020 to December 2022 from the French National Pharmacovigilance Database (BNPV). We identified the cases related to ketamine use among people with substance use disorder and described them.
There was a 2.5-fold increase in the number of ketamine users with substance use disorder in the OPPIDUM program, from 35 (0.7%) subjects in 2012 to 89 (1.7%) subjects in 2021. There was an increase in the proportion of subjects who were daily users, had distress upon discontinuation, and presented addiction. There were 238 cases related to ketamine use among people with substance use disorder in the French National Pharmacovigilance Database from July 2020 to December 2022. Among them, 94 (39.5%) cases involved ketamine use disorder, 20 (8.4%) cases involved urinary tract and kidney symptoms, and 13 (5.5%) cases involved hepatobiliary symptoms.
The trend observed over 10 years reflects the growth in ketamine use among people with substance use disorder, although it does not allow to estimate the rates of non-medical use of ketamine in the general population. Ketamine-induced uropathy and cholangiopathy are reported in ketamine users with substance use disorder, especially in case of repeated and/or prolonged use of high doses.
由于其致幻作用，氯胺酮已成为一种非医疗目的使用的药物。
评估物质使用障碍患者中氯胺酮使用的最新趋势，并利用法国药物警戒网络的补充健康数据源描述其临床并发症。
首先，我们从 OPPIDUM 项目数据库（即一个与数百个药物滥用治疗机构合作开展的多中心项目，收集有物质使用障碍的受试者使用药物的数据）中提取了 2012 年至 2021 年所有涉及氯胺酮的报告。我们全面描述了报告，并描述了 2012 年至 2021 年的变化。其次，我们从法国国家药物警戒数据库（BNPV）中提取了 2020 年 7 月至 2022 年 12 月期间所有涉及氯胺酮的病例。我们确定了有物质使用障碍的氯胺酮使用者的病例，并对其进行了描述。
OPPIDUM 项目中物质使用障碍患者的氯胺酮使用者数量增加了 2.5 倍，从 2012 年的 35 名（0.7%）增加到 2021 年的 89 名（1.7%）。每日使用者、停药时出现困扰和成瘾的比例增加。在 2020 年 7 月至 2022 年 12 月期间，法国国家药物警戒数据库中有 238 例与物质使用障碍患者使用氯胺酮相关的病例。其中，94 例（39.5%）为氯胺酮使用障碍，20 例（8.4%）为泌尿道和肾脏症状，13 例（5.5%）为肝胆症状。
10 年来的趋势反映了物质使用障碍患者中氯胺酮使用的增长，尽管无法估计普通人群中氯胺酮的非医疗使用率。在有物质使用障碍的氯胺酮使用者中，报告了氯胺酮引起的尿路和胆管疾病，特别是在重复和/或长时间使用高剂量的情况下。
