| 摘要: | 目的：本研究是採取病例對照研究方式，探討非法藥物使用再犯行為的相關因素，並描述非法藥物使用者藥物使用的情形。
方法：以監獄及戒治所之成年男性為研究對象，採集束抽樣方式進行抽樣，個案組為監獄中收容之毒品五年內再犯個案（n=173），以及戒治所中的五年內再犯個案（n=15）和五年後再犯個案（n=42）。而對照組則為監獄曾經因施用毒品而接受觀察勒戒之毒品初犯個案（n=17）及戒治所內之毒品初犯個案（n=30）。以不記名自填問卷收集資料包括社會人口、個人消費能力、家庭及社會環境的動力因素、個人心理健康及行為表現及成癮藥物使用的情形包括用藥的種類及時間等。
結果：經複邏輯斯迴歸分析影響非法藥物使用再犯行為的相關因素如下：(1)五年後再犯組與初犯組比：比起無家人使用成癮藥物者，有家人使用之勝算比(Odds Ratio; OR)為5.63(95% C.I.=1.12~28.2)。(2)五年內再犯組與初犯組比：生活費是家人給的相較於自己賺來的於五年內再犯行為之勝算比為4.18(95% C.I.=1.37~12.8)、海洛因總使用月數愈長，5年內再犯勝算愈高(OR=1.01，95% C.I.=1.00~1.02) 、比起無使用過(甲基)安非他命，有使用過者5年內再犯之OR為3.54(95% C.I.=1.60~7.81)。(3)五年內再犯組與五年後再犯組相比：生活費是家人給的相較於自己賺來的，再犯者於五年內再犯之勝算為五年後再犯之3.35倍(95% C.I.=1.20~9.35)、使用過海洛因再犯之勝算比為4.54(95% C.I.=1.54~13.4)、家庭整體關懷度愈高，5年內再犯之勝算比為1.11(95% C.I.=1.03~1.21)。藥物濫用行為與菸酒檳榔使用有很高的共存現象，受訪者中菸酒檳榔三種物質的使用比率都高達九成以上。受訪者使用的成癮藥物以海洛因為主(91.7%)，其次為(甲基)安非他命(79.1%)。來源以藥頭/毒販為主(76.5%)，使用地點以家中佔多數，有七成多。
結論： 不論是初犯組或是再犯組用藥的類型大致相同，都以海洛因及(甲基)安非他命為主，而受訪者的生活費來源、家庭整體關懷程度及用藥史可能都是影響非法藥物使用再犯行為的相關因素。然而本研究中所發現的家庭關懷度之相關性，有可能是行為之因而果，因為5年內再犯者可能因情形較嚴重，家人因此投注的關懷較多所致。總之防治成癮藥物使用者之再犯應加強個人及家庭因素，如以個案為中心的輔導之介入方式，並配合司法單位積極地查緝販毒網絡以杜絕成癮者對毒癮的接觸，多面向的進行再犯行為之防治工作，本研究結果能提供相關單位防治工作之參考。
Objectives: The purposes of this study are to investigate the patterns of illicit drug use and to explore the correlates associated with the reoccurrence of the illicit drug use among illicit drug users.
Methods: We conducted a cross-sectional study by using a case-control design for the data analysis. Cases were the illicit drug users arrested by the police twice or more than twice because of their reusing behaviors. Users only with first time arrested records on illicit drug use were control subjects. Our study subjects were all males and recruited from a male prison and a drug treatment center in Taiwan. An anonymously self-reported questionnaire was used to collect information on the illicit drug use and reuse behaviors, and the information on socio-demographic status, the source of individual’s living expenditure, individual psychological factors and health-risk behaviors, and family and social dynamic factors. According to the Act of the Ban of Illicit Drug Use, we divided the illicit drug reusers into two groups: one group consisted of users arrested by the police again within five years, and the other group was the users whose second arrested time was over five years later since their first arrested time. We finally identified 47 controls and 230 cases (188 were in the within five-year group, and 42 were in the over five-year group).
Results: Three multiple logistic regression models were used to explore factors related to reusing the illicit drug. Odds ratio (OR) and 95% confidence interval (C.I.) were calculated to estimate the association between the reusing behavior and the risk factors. (1) Compared with controls, cases whose second arrested time was over five-year later since their first time were more likely to have family members with illicit drug use (OR=5.63, 95%CI=1.12-28.2). (2) Compared with controls, cases whose second arrested time was within five years since their first time were more likely to have their living expenditure from their own families (OR=4.18, 95%CI=1.37-12.8), and to use heroin with longer months (OR=1.01, 95%CI=1.00-1.02), and to use methamphetamine (OR=3.62, 95%CI=1.93-8.26). (3) Compared with cases in over five-year group, cases in within five-year group were more likely to have the living expenditure from their own families (OR=3.35, 95%CI=1.20-9.35)、to use heroin with longer months (OR=4.54, 95%CI=1.54-13.4) and have family support (OR=1.01, 95%CI=1.03-1.21).
This study also found a high correlation between illicit drug use and smoking, drinking and chewing areca quid behaviors. More than 90% subjects were users of the above-mentioned substances, including heroin being used by 91.7% of study subjects, and methamphetamine by 79.1% of subjects. The drug dealers (76.5%) were the major source of illicit drugs obtained from. Home was the primary place for them to use those.
Conclusion: The illicit drug use patterns between cases and controls are similar in our study populations, the primary illicit drugs used by both groups were heroin and methamphetamine. The source of living expenditure, family support and having the history of illicit drug use were associated with the behaviors of reusing the illicit drug. The implementation of drug abuse prevention needs more individual-centered intervention programs with the enhanced family support, and needs more efforts on breaking the drug selling networks down by the police department. |
