Robson P, Bruce M
Chilton Clinic, Warneford Hospital, Oxford, UK.
Addiction. 1997 Dec;92(12):1729-36.
To compare the characteristics of heroin, cocaine and amphetamine users having no history of contact with services with those of a group in contact.
Multiple agency sampling and field work which included 'snowballing' using 'privileged access interviewers'. Each subject underwent a structured interview which included the Severity of Dependency Scale (SDS), and completed a confidential, self-report questionnaire.
Three contrasting provincial urban locations.
Five hundred and eighty-one regular users of the target drugs. Of these, 380 (65%) denied any contact with police or helping agencies in connection with drug use.
Most zero-contact users (79%) expressed little or no concern about their drug use, and no wish for help or advice. They were much more likely to use stimulants only; less likely ever to inject any drug or, for those that did, to share equipment; less likely to use opioids, amphetamine or cocaine powder on a daily basis; more likely to use Ecstasy; and yielded significantly lower SDS scores for all target drugs save crack. Prevalence of crack use was lower, but the proportion of daily users was the same as in the contact group. Most (69%) contact users remained concerned about their drug use, but 58% expressed little or no confidence that local services could meet their needs. In both groups, SDS scores for cocaine powder were comparable to those for cannabis, LSD and Ecstasy. Of the 495 cannabis smokers identified (85% of the sample), 72% reported daily consumption.
The findings are consistent with the hypothesis that 'visible' and 'invisible' drug users are distinct populations in terms of behavioral characteristics, vulnerability to compulsive use, and prevalence of drug-related problems or concern. Purchasers and providers with limited resources should concentrate on improving the range and quality of services for users already in contact rather than attempting to uncover invisible populations. On the basis of SDS scores, cocaine HCI seems to have a relatively modest addictive potential.
比较未曾接触过服务机构的海洛因、可卡因和苯丙胺使用者与接触过服务机构的一组使用者的特征。
多机构抽样和实地调查，包括利用“有特权的访问访谈员”进行“滚雪球”抽样。每位受试者都接受了一次结构化访谈，其中包括依赖严重程度量表（SDS），并完成了一份保密的自我报告问卷。
三个不同的省级城市地区。
581名目标药物的经常使用者。其中，380人（65%）否认在吸毒方面与警方或救助机构有过任何接触。
大多数零接触使用者（79%）对自己的吸毒行为很少或根本不担心，也不希望得到帮助或建议。他们更有可能只使用兴奋剂；注射任何毒品的可能性较小，或者对于注射毒品的人来说，共用设备的可能性较小；每天使用阿片类药物、苯丙胺或可卡因粉末的可能性较小；使用摇头丸的可能性较大；除快克外，所有目标药物的SDS得分均显著较低。快克的使用率较低，但每日使用者的比例与接触组相同。大多数（69%）接触过服务机构的使用者仍对自己的吸毒行为感到担忧，但58%的人表示对当地服务机构满足其需求的信心很小或没有信心。在两组中，可卡因粉末的SDS得分与大麻、麦角酸二乙酰胺（LSD）和摇头丸的得分相当。在确定的495名大麻吸食者中（占样本的85%），72%报告每日吸食。
研究结果与以下假设一致，即“显性”和“隐性”吸毒者在行为特征、强迫性使用的易感性以及与毒品相关问题或担忧的发生率方面是不同的人群。资源有限的购买者和提供者应专注于改善为已接触服务机构的使用者提供的服务范围和质量，而不是试图发现隐性人群。根据SDS得分，盐酸可卡因似乎具有相对适度的成瘾潜力。
