利用全國多城市街頭外展探討蹺家青少年之精神作用物質使用

Abstract

目的：先前研究已發現住在收容所或是無家可歸的青少年有較高的物質使用率，然而對於住在家裡，只偶爾嘗試蹺家的青少年的物質使用情形仍少有研究探討。本研究分析有輕微蹺家經驗的青少年，其物質使用的危險性是否較沒有蹺家經驗者高。 方法：三年街頭外展計畫在全國26個城市，以匿名自我填報問卷作為收案工具，自2004至2006年分別收集了6014、6516、與6405筆樣本。對於蹺家經驗，以兩個不同分類方法進行分組：﹝一﹞嚴重性：未蹺家、嘗試性蹺家﹝只有一次且為期一天以內﹞、延伸性蹺家﹝兩次以上或最長連續天數兩天以上﹞；﹝二﹞時間性：未蹺家、剛蹺家﹝最近半年內開始蹺家﹞、過去式蹺家﹝半年前有蹺家經驗但近半年內沒有﹞、習慣性蹺家﹝半年前與近半年內皆有蹺家經驗﹞。 結果：此外展計畫捕抓到2.6-3.4% 的嘗試性蹺家與 6.3-8.7%的延伸性蹺家青少年。與從未蹺家者相比，延伸性蹺家青少年有1.9-3.0之使用物質的危險勝算比，嘗試性蹺家者使用物質的危險勝算比較低，但仍大於1且達統計顯著。此外，剛蹺家的青少年已有較高抽菸、喝酒、與使用非法藥物的危險性，但沒有顯著嚼檳榔的危險性。 結論：有嘗試蹺家經驗的青少年已有較高物質使用的危險性，而大部分青少年蹺家的發生時間則在抽菸與喝酒之後，但在開始嚼檳榔與使用非法藥物之前。

Objective: Shelters youths and street youths have been found to be vulnerable to a variety of psychoactive substance use. However, little is known whether youths living with family with only trial runaway experience already have higher substance use rate. This study aimed to investigate associations linking runaway experience, in terms of severity and recency, to substance involvement in adolescents. Methods: Samples were derived from a three-year street outreach program across 26 cities/towns in Taiwan between 2004 and 2006. A total of 6014 participants for 2004, 6516 for 2005, and 6405 for 2006 completed the questionnaire. The data were collected with an anonymous, self-administered paper-and-pencil questionnaire. Two classified ways were adopted: (i) By severity: never runaway, trial runaway (only 1 time and having longest time≦ 1 day), and extended runaway (at least 2 times or having longest runaway time＞ 1 day). (ii) By recency: never runaway, new runaway (starting in recent six months), past runaway (ever runaway half a year before but not in recent six months), and regular runaway (having runaway both in recent six months and half a year before). Results: The proportion of participants reporting experience of runaway was 2.6-3.4% for trial runaway and 6.3-8.7% for extended runaway. Compared with persons never having runaway, those with extended runaway had increased risk for substance use (OR ranging from 1.9-3.0). Although the corresponding increases in the risk for substance use were of less magnitude for those having trial runaway, the ORs were significantly greater than 1. In addition, youths with new runaway had higher risk for recent use of tobacco, alcohol, and illegal drug, but not for betel nut. Conclusions: Youths with trial runaway experience had already had higher risk for substance use. In addition, the majority of youths’ first runaway followed the initiation of alcohol and tobacco use, but preceded the initiation of betel nut and illegal drug use. Our findings have implications for the prevention or intervention of adolescent substance use.