台北都會區菸酒慣用者之愷他命期待與愷他命終生使用經驗

Abstract

目的：本篇研究主要的目的有二，其一是分別探討愷他命的正向及負向期待分數和愷他命過去的終生使用經驗是否有所相關；其二是利用正向和負向期待的高低分數組合去了解各種期待分數組合和愷他命過去的終生使用經驗以及相關行為是否有所相關。 方法：將2007年到2010年以「回應者引介抽樣法」在大台北地區收集的菸酒慣用者作為研究的樣本的來源，四年所蒐集的樣本數總共為1130人。我們將樣本中未完成愷他命期待問卷以及未曾使用過愷他命但是曾使用過其他非法藥物的使用者在分析前事先挑出，最後有1012人納入研究分析。每一位受訪者都利用電腦經過了「自我訪談式問卷」的資料蒐集，分別蒐集了愷他命的期待分數、藥物的終生使用經驗以及其他面向的測量。利用卡方檢定或是變異數分析做群組間的比較，並且以多分類反應變數的羅吉斯回歸做為依變項和自變項之間相關程度的分析。 結果：以過去使用愷他命的經驗將樣本分為未使用非法藥物(n = 845, 83%)、僅使用愷他命(n = 30, 3%)以及曾合併愷他命以及其他藥物使用(n = 137, 14%)三組。以三組不同的愷他命終生使用經驗作為依變項與正向和負向的愷他命期待進行多分類反應變數的羅吉斯回歸。以未使用非法藥物的組別做為參考組，發現正向的愷他命期待和過去僅使用愷他命的組別(OR = 1.51, p < 0.01)及過去曾有合併愷他命以及其他藥物使用的組別(OR = 1.68, p < 0.001)有顯著的正向相關；而負向的愷他命期待則和過去僅使用愷他命的組別(OR = 0.80, p < 0.05)及過去曾合併愷他命以及其他藥物使用的組別(OR = 0.70, p < 0.001)有顯著的負向相關。之後以未使用非法藥物的組別分別在正向以及負向的愷他命期待的中位數作為切點，將兩種期待分數分別進行高低分的區分後再加以組合，以正向分數低負向分數高的組別做為參考組，再和不同的愷他命終生使用經驗進行多分類反應變數的羅吉斯回歸，發現在正向分數高負向分數低的組別與過去僅使用愷他命的組別(OR = 3.28, p < 0.05)及過去曾有合併愷他命以及其他藥物使用的組別(OR = 41.21, p < 0.0001)有顯著的正向相關。 討論與結論：本研究針對新興藥物-愷他命進行愷他命終生使用經驗與其期待分數的分析，了解了不同的愷他命終生使用經驗對於期待分數的關係，對於未來進一步的愷他命的防治或是介入提供了新的資訊可以參考。

Aims: The present study aimed to (a) examine whether the positive and negative expectancy, respectively, was associated with ketamine-using behavior, and (b) explore the relationship between different combinations of dichotomized positive-negative expectancy and ketamine-using behavior. Methods: Study subjects were participants recruited by using respondent driven sampling among regular alcohol and tobacco users in Taipei metropolitan area from 2007 to 2010. The total number of newly-recruited subjects in each year during the 4 years was 1130. After excluding subjects whose repertoire of illegal drug use did not include ketamine, or who failed to complete the questionnaires on expectancy, the final sample size for this study was 1012. Each participant underwent an audio computer-assisted self-interview for previous experience of drug use, expectancy of ketamine use, and other measurements. Group comparisons were conducted using either chi-square test or ANOVA, and correlates of a multi-group outcome were examined using multinomial logistic regression. Results: According to ketamine-use experience, subjects were categorized into 3 groups: illegal drug naive (N = 845, 83%), ketamine use only (N = 30, 3%) and ketamine use with other drugs (N = 137, 14%). Results from multinomial logistic regression analysis indicated that positive expectancy was positively associated with ketamine use only (OR = 1.51, p < 0.01) and ketamine use with other drugs (OR = 1.68, p < 0.001); in contrast, negative expectancy inversely associated with ketamine use only (OR = 0.80, p < 0.05) and ketamine use with other drugs (OR = 0.70, p < 0.001). Then we used the median of positive and negative expectancy among illegal drug naive, respectively, to dichotomize expectancy into high vs. low subgroups. Using the subgroup of low-positive plus high-negative as reference, the results of multinomial logistic regression analysis revealed that subgroups of high-positive plus low-negative was positively associated with ketamine use only (OR = 3.28, p < 0.05) and ketamine use with other drugs (OR = 41.21, p < 0.0001). Discussion and Conclusions: This study helped shed light on the relationship between different ketamine-using patterns and ketamine expectancy, and then provided new information for the intervention or prevention of ketamine use.