本文選題：毒品濫用 + 農村地區(qū)　； 參考：《中南大學》2012年博士論文

【摘要】：第一部分湖南農村地區(qū)毒品濫用的初步調查 目的：比較湖南省農村地區(qū)和城市地區(qū)毒品濫用的特點和模式的差異。 方法：分別收集和分析湖南省5個農村地區(qū)和5個城市地區(qū)1639例(農村地區(qū)827例,城市地區(qū)812例)2005年至2008年之間公安部門新登記在冊吸毒人員的相關資料,包括一般人口學資料,初次使用毒品的年齡,毒品使用時間,毒資來源,毒品使用類型、方式、劑量,戒毒治療史,風險行為,違法犯罪記錄等 結果：相比城市地區(qū),農村地區(qū)的吸毒人員年齡較小(31±6.6歲vs.34±8.0歲,p0.001),且男性(86%vs.82%,p0.05)和已婚者(34%vs.27%,p0.01)居多；此外,農村地區(qū)的吸毒人員在年齡較小的時候就開始使用毒品(27±5.9歲vs.30±7.9歲,p0.001),并且大多以海洛因為主(53%vs.47%,p0.001),然而違法犯罪率較低(19%vs.31%,p0.001),共用針具((1.8%vs.4.3%,p0.01)和HIV陽性者較少(0.8%vs.2.6%,p0.01),且較少的吸毒人員有過戒毒治療史(2.8%vs.6.8%,p0.001)。 結論：無論在城市還是在農村地區(qū),毒品濫用已成為一個重要的社會問題。然而由于戒毒醫(yī)療服務在農村地區(qū)的短缺等原因,農村地區(qū)吸毒人員獲得戒毒治療的機會甚少,因此我們要重視農村地區(qū)戒毒治療的推廣 第二部分湖南農村地區(qū)的毒品濫用：焦點小組研究 目的：從毒品濫用者的角度定性探討湖南農村地區(qū)毒品濫用的模式和特點。 方法：采用焦點小組的方法分別對婁底、岳陽和衡陽農村地區(qū)的毒品濫用者進行集體訪談(每個焦點小組包括6-7名毒品濫用者,共進行6次焦點小組訪談,每個地區(qū)各2次),同時對訪談進行錄音和現場記錄。然后反復聽取錄音,逐字逐句將錄音轉化成文字。采用解釋性描述的方法對文字資料進行歸納分析。 結果：湖南農村地區(qū)的毒品濫用非常流行。新增加的毒品濫用者主要使用新型毒品(以麻古和冰毒最為流行),多種毒品濫用的現象十分普遍；主要的毒品使用方式為煙吸和靜脈注射：絕大多數的毒品濫用者是在好奇心和虛榮心的驅使下通過朋友介紹初次接觸毒品,認為毒品可以改善抑郁情緒、提高性欲、緩解軀體不適；在農村地區(qū)同樣很容易獲得毒品,販毒者主要包括絕癥患者和長期使用毒品者：農村地區(qū)可獲得的治療資源相對較少,以自己在家里戒毒和強制性戒毒為主；社會歧視,無法脫離毒品濫用的社交圈常導致戒毒治療失��；經濟困難和害怕治療是兩大主要的治療障礙。 結論：毒品濫用已成為農村地區(qū)的一個重要的社會問題。新型毒品的流行和多種毒品濫用的現象會使農村地區(qū)的毒品控制變得更為復雜。政府部門除了加大農村地區(qū)戒毒治療服務的建設外,更應加強新型毒品危害的宣傳,改變社會大眾對毒品濫用者的態(tài)度,給予心理干預,幫助毒品濫用者重新回歸社會。 第三部分湖南城鄉(xiāng)地區(qū)毒品濫用的定量研究 目的：通過現場問卷調查,比較湖南城鄉(xiāng)地區(qū)毒品濫用模式和特點以及毒品濫用者的沖動人格、抑郁情緒、睡眠質量和治療障礙問題的差異,更進一步了解湖南農村地區(qū)毒品濫用的情況。 方法：采用成癮嚴重性指數量表(ASI)、巴瑞特沖動性人格量表(BIS)、CES-D抑郁自評量表、匹茲堡睡眠質量指數量表(PSQI)和治療障礙評定問卷(BTI)對437例毒品濫用者的毒品使用情況、毒品相關問題以及沖動人格、抑郁情緒、睡眠質量和治療障礙進行調查分析。 結果：(1)在農村地區(qū),52.7%的吸毒者在當地第一次接觸毒品,25.2%的吸毒者在外地打工時第一次接觸毒品；(2)與城市地區(qū)相比,農村地區(qū)的吸毒者年齡更小(32.4±6.4歲vs.30.9±6.6歲,p0.05),男性占的比例更多(55.2%vs.80.7%,p0.001),已婚率更高(27.3%vs.41.6%,p0.05),受教育程度更低(9.6±3.0vs.8.8±2.5,p0.01)；(3)與城市地區(qū)相比,農村地區(qū)海洛因和K粉的使用率更高(p0.05),而農村和城市地區(qū)冰毒的使用率無顯著差異(p=0.167)；(4)農村和城市地區(qū)吸毒者的靜脈注射毒品率無顯著差異(p=0.828),但農村地區(qū)吸毒者的共用針具率顯著高于城市地區(qū)(18.5%vs.7.8%,p0.01)；(5)與城市地區(qū)相比,農村地區(qū)吸毒者的毒品使用時間較短(5.3±4.2年vs.6.6±5.2年,p0.01)；(6)農村和城市地區(qū)吸毒者的治療次數、未治療率、強制戒毒治療率、社區(qū)戒毒治療率,自愿門診和住院治療率、無顯著統計學差異。僅農村地區(qū)吸毒者的MMT治療率顯著低于城市地區(qū)(27.1%vs.38.6%,p0.05)；(7)與城市地區(qū)相比,農村地區(qū)吸毒者的治療時間與日常工作沖突因子分和治療場所難以進入因子分更低(p0.05) 結論：研究結果提示毒品濫用已經滲透到農村地區(qū),并已成流行之勢。以前去外地打工染毒,再回當地使用的模式已經向當地滋生出毒品濫用者的模式轉變；城鄉(xiāng)地區(qū)吸毒者的戒毒治療模式基本上一致,強制性戒毒為主要的戒毒治療方式；農村地區(qū)的MMT資源相對缺乏；就農村地區(qū)的吸毒者而言,來自治療時間和日常工作沖突以及治療場所難以進入(包括經濟困難)方面的治療阻礙更大。因此,我們應針對農村地區(qū)毒品濫用的模式和特點,采取合適和有效的措施提高戒毒治療率,減少復吸。
[Abstract]:The first part is a preliminary investigation of drug abuse in rural areas of Hunan.
Objective: To compare the characteristics and patterns of drug abuse in rural and urban areas of Hunan province.
Methods: the data of new registered drug addicts in 5 rural areas and 5 urban areas in Hunan province (827 rural areas and 812 urban areas) from 2005 to 2008 were collected and analyzed, including the general demographic data, the age of the first use of drugs, the time of drug use, the source of drug use, the use of drugs, and the use of drugs. Type, mode, dosage, history of drug treatment, risk behavior, criminal record, etc.
Results: compared to urban areas, the age of drug addicts in rural areas was smaller (31 + 6.6 years old vs.34 + 8 years old, p0.001), and male (86%vs.82%, P0.05) and married people (34%vs.27%, P0.01) were most; in addition, drug addicts in rural areas began to use drugs at the age of younger (27 + 5.9 years vs.30 + 7.9 years, p0.001), and most of them were in halo. Because the 53%vs.47% (p0.001), however, the rate of crime is low (19%vs.31%, p0.001), the common needle (1.8%vs.4.3%, P0.01) and HIV positive people are less (0.8%vs.2.6%, P0.01), and fewer drug addicts have a history of drug treatment (2.8%vs.6.8%, p0.001).
Conclusion: drug abuse has become an important social problem in both urban and rural areas. However, because of the shortage of medical service in rural areas, drug addicts in rural areas have little chance to get drug treatment. Therefore, we should pay attention to the promotion of drug treatment in rural areas.
The second part is drug abuse in rural areas of Hunan: focus group study.
Objective: To explore the patterns and characteristics of drug abuse in rural areas of Hunan from the perspective of drug abusers.
Methods: a group of focus groups were used to conduct collective interviews with drug abusers in Loudi, Yueyang and Hengyang (each focus group, including 6-7 drug abusers, 6 focus group interviews, 2 times in each area), recording and recording interviews at the same time. The recording is translated into text. The text is analyzed by interpretive description.
The result: drug abuse in rural areas of Hunan is very popular. The new drug abusers are mainly using new drugs (the most popular with narcotic and ice poison), and many kinds of drug abuse are common; the main use of drugs is smoking and intravenous injection: the overwhelming majority of drug abusers are in curiosity and vanity. By introducing first exposure to drugs by friends, it is believed that drugs can improve depression, sexual desire, and somatic discomfort; drugs are also readily available in rural areas, and drug traffickers mainly include terminally ill patients and long-term drug users: less resources available in rural areas, detoxification and coercion at home. Sexual detoxification is the main factor; social discrimination, which can not be separated from the social circle of drug abuse, often leads to the failure of drug treatment, and economic difficulties and fear of treatment are the two major treatment barriers.
Conclusion: drug abuse has become an important social problem in rural areas. The epidemic of new drugs and the phenomenon of a variety of drug abuse will make the drug control more complex in rural areas. In addition to increasing the construction of drug treatment services in rural areas, the government departments should strengthen the propaganda of new drug hazards and change the society. Many people give psychological intervention to drug abusers' attitudes to help drug abusers return to society.
The third part is quantitative research on drug abuse in urban and rural areas of Hunan.
Objective: To compare the patterns and characteristics of drug abuse in urban and rural areas of Hunan, and to compare the differences in the impulsive personality, depression, sleep quality and treatment barriers of drug abusers, and further understand the drug abuse in rural areas of Hunan.
Methods: the Addiction Severity Index Scale (ASI), the Barrett impulsive personality scale (BIS), the CES-D self rating depression scale, the Pittsburgh sleep quality index (PSQI) and the treatment disorder assessment questionnaire (BTI) were used for drug use, drug related problems and impulsive personality, depression, sleep quality and treatment disability in 437 drug abusers. The obstruction was investigated and analyzed.
Results: (1) in rural areas, 52.7% of the drug addicts were first exposed to drugs in the local area, and 25.2% of the drug users were first exposed to drugs in the field. (2) compared with the urban areas, the drug addicts in the rural areas were younger (32.4 + 6.4 years vs.30.9 + 6.6, P0.05), and the proportion of men was more (55.2%vs.80.7%, p0.001), and the married rate was higher (27.3). %vs.41.6%, P0.05), lower education (9.6 + 3.0vs.8.8 + 2.5, P0.01); (3) compared with urban areas, the use of heroin and k powder in rural areas is higher (P0.05), but there is no significant difference in the use rate of ice in rural and urban areas (p=0.167); (4) there is no significant difference between the drug rate of drug users in rural and urban areas (p=0.828). However, the sharing needle rate of drug addicts in rural areas was significantly higher than that in urban areas (18.5%vs.7.8%, P0.01); (5) the drug use time of drug addicts in rural areas was shorter than that in urban areas (5.3 + 4.2 years vs.6.6 + 5.2 years, P0.01); (6) the treatment times of drug addicts in rural and urban areas, the rate of untreated treatment, the rate of compulsory detoxification, and community drug treatment treatment. There was no significant difference in the rate of treatment, voluntary outpatient and hospitalization rates. Only the MMT rate of drug addicts in rural areas was significantly lower than that in urban areas (27.1%vs.38.6%, P0.05). (7) compared with urban areas, the treatment time of drug addicts in rural areas was lower than that of daily work conflict factors and the treatment sites were difficult to enter the factor (P0.05).
Conclusion: the results suggest that drug abuse has penetrated into the rural areas and has become a popular trend. The pattern of drug abusers who had gone to the field and then returned to local use had changed the pattern of drug abusers. The drug addicts in urban and rural areas were basically the same, and compulsory detoxification was the main treatment for drug abstinence. Methods: the MMT resources in rural areas are relatively lack; for drug users in rural areas, treatment time and daily work conflict and treatment places difficult to enter (including economic difficulties) are more obstructed. Therefore, we should take appropriate and effective measures against the patterns and characteristics of drug abuse in rural areas. The rate of high abstinence treatment and reduction of relapse.
【學位授予單位】：中南大學
【學位級別】：博士
【學位授予年份】：2012
【分類號】：R749.64

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