利用液相層析串聯質譜儀測定與分析特定族群之尿液中濫用藥物之使用情形

Abstract

本計畫利用高壓液相層析串聯質譜儀建立濫用藥物分析方法以及完成106年臺灣特定族群人員之尿液檢體中濫用藥物之檢驗，並調查特定族群人員藥物濫用現況及趨勢。檢測特定族群尿液檢體607件，檢驗之項目包含安非他命類、鴉片類、大麻類、古柯鹼類、愷他命類、苯二氮平類、新興濫用藥物(包含卡西酮類和類大麻活性物質等)及其他等60種濫用藥物。上述60種濫用藥物及其相關代謝物之方法已開發，利用尿液稀釋法搭配液相層析之質譜儀(LC-MS/MS，Sciex QTRAP® 6500)，快速偵測樣品中之濫用藥物成分，可準確監測高危險群，如毒品嫌疑犯族群是否施用濫用藥物的現象，另一方面，以監測調查方式進行，了解新興濫用藥物品項，並評估是否有濫用之趨勢，作為例行性檢驗項目之參考，以資管理應用，有助於制定具成本效益的預防策略。本研究計畫採取系統性隨機抽樣方式抽驗105年9月至106年8月期間全國各縣市警察局送至衛生福利部認可濫用藥物尿液檢驗機構檢驗之涉嫌毒品案件尿液檢體，總共收集1108件尿液檢體，回收866份基本資料表，有效問卷607份，前三大檢出品項比例排名為(甲基)安非他命、愷他命類及鴉片類藥物。安非他命及甲基安非他命之檢出率為55.5%；愷他命類之檢出率為24.7%；而鴉片類之檢出率為18.5%，中位數為36歲；性別均以男性為主；藥物檢出者的教育程度集中分布於國中至高中(職)；職業分布以工、待業為主；犯罪情形以累犯最多；場所集中於道路及留宿場所；查獲方式以路檢稽查為主。由這些特定族群的分布情形可以得知肘些藥物的加強防治與資料集中的群體等資訊，提供相關單位警政權法一個有利的證據加以政策的制定。

Drug abuse has become a global issue of concern. It affects not only public health, but also social security. In the study, a sensitive and selective liquid chromatography-tandem mass spectrometry method is developed for fast identification of common drugs of abuse, psychoactive drugs and their metabolites in urine. In the study, a sensitive and selective ultrahigh-performance liquid chromatography-tandem mass spectrometry method is developed for fast screening simultaneously of common drugs of abuse, psychoactive drugs and metabolites in urine specimens. We surveyed the laboratory analytical data of urine samples collected from suspects who were arrested for possessing and/or taking illicit drugs and estimated the illicit drug use trends in Taiwan. Six hundred and seven samples and questionnaires collected from September 2016 to August 2017 were analyzed. Dilute-and-shoot method was applied to sample pretreatment. The detection rate of drugs of abuse was higher on men than on women. The median age of the drug of abusers was thirty-six years old. Most of the subjects were awarded a junior/senior high school diploma. Among occupations, the majority of cases were the blue-collar workers and the unemployed. In criminal history, recidivism had the highest drug abuse rate (78.3%) of all positive cases, followed by first offense (21.7%). Most of the subjects were arrested on roadside and residence. In all drugs, amphetamine and methamphetamine had the highest drug abuse rate (55.5%) of all positive cases, followed by ketamine (24.7%) and opiates (18.5%). In new psychoactive substances, mephedrone had the highest drug abuse rate (7.08%) followed by methylone (2.97%). The detection rate of methadone or buprenorphine was 2.8%. Furthermore, statistics were used to report the distribution rate and patterns of drug abuse. In addition, linear regression was applied to determine the trends of drug abuse. The results from the high-risk group provides significant information to understand the prevalence of drug abuse and help the authority for building up the public policy.