Mokhtarpoor Hassan, Tehranineshat Banafsheh, Naderi Zeinab, Amirinia Maryam
Shiraz University, Shiraz, Iran.
Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Heliyon. 2024 Nov 22;10(23):e40620. doi: 10.1016/j.heliyon.2024.e40620. eCollection 2024 Dec 15.
The high prevalence of multiple substance use (MSU) is concerning, given the weak awareness about this issue and the potential impact this unawareness has on the severity of substance use disorder (SUD) and treatment outcomes. The aim of this study is to identify and elucidate the causes and motivations for MSU from the viewpoints of users and therapists in this field.
In this qualitative study, the conventional content analysis approach and purposive sampling were utilized. Deep semi-structured exploratory interviews were conducted with 17 substance users and 8 addiction therapists (including 4 psychiatrists, 3 general practitioners, and 1 psychologist). Field notes were also taken to identify and explain the motivations and reasons for MSU from the perspectives of users and therapists. The data were analyzed comparatively and simultaneously using the method suggested by Graneheim and Lundman (2004).
Based on the findings of this study, the motivations for MSU are reflected in four main categories: 'Pharmacological factors' with subcategories such as achieving desired states and mitigating the undesirable effects of substances through leveraging the balancing, synergistic, and antagonistic effects of substances, substituting the effects of other substances, self-medication of the undesirable effects of other substances, enhancing the overall consumption experience such as heightened peak experience and enhanced pleasure, moderating the come-down, and seeking euphoria experiences in different substances; 'Biological factors' with subcategories including different neurobehavioral systems, individual differences determining substance dependence and the somatic-neural vulnerability of consumers; 'Psychosocial factors' with the subcategories of undesirable norms like the need for acceptance and social interactions, the context of substance use, consumers' experiences and expectations of substance use, and the maladaptive personality traits of consumers; and 'Addiction's inevitability' with the subcategories of coercion and the need to maintain equilibrium, and the difficulties of substance detoxification.
The motivations behind Multiple Substance Use (MSU) behaviors are multifaceted, including pharmacological, biological, psychosocial, and addiction-related factors. Recognizing and comprehending the interplay between these factors and motivations can inform better prevention strategies, assessment of treatment needs, and enhancement of treatment outcomes for individuals dealing with MSU.
鉴于对多种物质使用（MSU）问题的认识不足，以及这种认识不足对物质使用障碍（SUD）的严重程度和治疗结果可能产生的影响，MSU的高患病率令人担忧。本研究的目的是从该领域的使用者和治疗师的角度识别并阐明MSU的原因和动机。
在这项定性研究中，采用了传统的内容分析方法和目的抽样法。对17名物质使用者和8名成瘾治疗师（包括4名精神科医生、3名全科医生和1名心理学家）进行了深度半结构化探索性访谈。还记录了实地笔记，以便从使用者和治疗师的角度识别并解释MSU的动机和原因。使用Graneheim和Lundman（2004）建议的方法对数据进行了比较和同步分析。
基于本研究的结果，MSU的动机体现在四个主要类别中：“药理学因素”，其亚类别包括通过利用物质的平衡、协同和拮抗作用来实现期望状态并减轻物质的不良影响、替代其他物质的作用、自我治疗其他物质的不良影响、增强整体消费体验（如增强高峰体验和愉悦感）、缓和药物作用消退期以及在不同物质中寻求欣快感体验；“生物学因素”，其亚类别包括不同的神经行为系统、决定物质依赖的个体差异以及消费者的躯体神经易损性；“心理社会因素”，其亚类别包括不良规范（如需要被接受和社交互动）、物质使用的背景、消费者对物质使用的体验和期望以及消费者的适应不良人格特质；以及“成瘾的必然性”，其亚类别包括强迫和维持平衡的需要以及物质戒毒的困难。
多种物质使用（MSU）行为背后的动机是多方面的，包括药理学、生物学、心理社会和成瘾相关因素。认识并理解这些因素与动机之间的相互作用，可以为更好地制定预防策略、评估治疗需求以及改善应对MSU的个体的治疗结果提供参考。
