大專生物質濫用現況與相關影響因素探討

Abstract

青少年物質使用似有逐年上升之勢，已成現今社會不容忽視的健康與社會問題之一。過去研究很早就發現青少年物質使用具有階段性，依序是酒、菸、大麻、其它非法藥物，國內資料亦顯示青少年非法物質使用亦與菸、酒等物質使用經驗有關。在未出現物質使用造成危害大眾和個人健康行為之前，瞭解大專生物質濫用現況、相關之危險因子及物質濫用進階層次，將有助於提出青少年物質濫用之防治與處遇因應策略，並且針對生、心理及社會行為未發展成熟之青少年建構較完善的保護機制，加強教育宣導和適切防制措施。 目的:（1）了解國內大專生藥物濫用現況;（2）了解大專生藥物濫用的進階層次;（3）評估與大專生藥物濫用相關的危險因子;（4）評估與大專生遠離藥物濫用的保護因子。 方法：本研究採取橫斷式描述性研究設計法，探討國內大專生藥物濫用的現況及物質濫用進階層次與大專生物質濫用之相關性。以大專校院學生為收案對象，採用方便取樣(convenience sampling)，選取經教育部承認之國、私立大學、國立、私立科技大學，以就讀大專學校院的學生為主；地點則於各學校教職人員安排合適的研究問卷填答場所。研究工具採用以「大專學生身心健康篩檢問卷」為基礎進行修改，回收問卷後，將有效問卷編碼並鍵入電腦，以統計套裝R 3.4.0軟體及SAS（9.4版）進行各種統計資料分析，包含次數分配、描述統計、單因子變異數分析和多元迴歸分析。 結果：本研究發現高達七成以上（74.5%）之大專院校學生有飲酒經驗，其次有抽菸經驗佔17.9%、曾使用鎮靜安眠藥佔4.5%、嚼食檳榔佔4.4%，可知目前大專學生使用酒精為數不少。同時研究也發現菸酒檳榔之使用與物質濫用相關，研究個案有菸酒檳榔使用行為者當中，有抽菸行為在使用非法物質有較高風險。研究對象喝酒、抽菸或是使用其他藥品者，後續容易出現較多的暴力或是違紀行為、有憂鬱情緒或是自殺紀錄、涉及不安全的性行為。就家庭方面而言，家庭成員互動衝突和親密度低可能導致青少年傾向於與偏差行為同儕聯繫。 結論：在成長發育的過程，校園若舉辦家長親職教育相關知能強化家庭功能，協助父母親及家人肩負並發揮出監督的角色及功能，可降低青少年接觸非法物質的風險。就朋友與同儕方面而言，大專生之交友情況與其偏差行為有關，因而物質使用可能性亦增加，建議校園可以提供生活技巧訓練，透過人際互動學習課程或活動，使學生學習拒絕不適當活動邀約或拒絕嘗試非法物質，期能促進同儕間的正向影響，以減少接觸使用非法物質的機會。

Substance use in adolescents seems to have increased on annual basis and has become one of the health and social problems that can no longer be ignored in the society. It was already found in the past that substance use in adolescents was phased in a sequential order of alcohol, tobacco, marijuana and then other illegal drugs. Domestic data also showed that the use of illegal substances by adolescents was also related to the experience in use of tobacco and alcohol. Understanding the current status of substance abuse in college students, as well as related risk factors and the gateway process of abusive behaviors, before endangering the public and individual health, will help to address the prevention and treatment of substance abuse in adolescents. Meanwhile, a more comprehensive protective strategy alone with educational programs and proper preventive interventions should be established for adolescents who are still not matured enough biologically, psychologically and socially. Objectives: (1) Understand the current situation of drug abuse among college students; (2) Understand the gateway process of drug abuse among college students; (3) Assess risk factors related to drug abuse in college students; (4) Assess protective factors for preventing college students from drug abuse. Method: This study adopted a cross-sectional descriptive research design to investigate the current situation of drug abuse among domestic college students and the correlation between their gateway process and substance abuse. Students from colleges and universities were research subjects and selected from convenience sampling. Selected schools included public and private universities and technology institutes certified by the Ministry of Education, but mostly were students attending colleges and universities. The faculty would arrange a suitable research venue for answering the questionnaire. The research tool was modified from the “Physical and Mental Health Screening Questionnaire for College Students”. After the questionnaires were collected, only valid ones were coded and keyed into the computer, where statistical analysis was performed by using R 3.4.0 software and SAS (version 9.4), including frequency distribution, descriptive statistics, one-way variance analysis and multiple regression analysis. Results: This study found that more than 70% (74.5%) of college students had drinking experience, followed by smoking (accounted for 17.9%); use of sedative and hypnotics (4.5%); and chewing betel nut, (4.4%), that many college students were involved in alcohol use. Moreover, the study also found that the use of tobacco, alcohol and betel nut was related to substance abuse. Among the cases in which tobacco and betel nut were used, students with smoking behavior showed higher risk in the use of illegal substances. Those who drank alcohol, smoked cigarettes, or used other drugs, might be more prone to violent behavior or violation of discipline, as well as higher rate of depression, suicide behavior and unsafe sex. In term of family, interactive conflict and low intimacy among family members could lead to adolescents associating with peers of delinquent behavior. Conclusion: During growth and development, if the campus organizes parent-child program on educating related knowledge to strengthen family function and assist parents and family members to shoulder the role of supervision, it can reduce the risk of exposure to illegal substances by the young people. As for friends and peers, friendship of a college student is certainly related to behavior deviation that the possibility of substance use can also increased. It is suggested that the campus can provide life skill training for students to learn to refuse inappropriate activities or use of illegal substances through interpersonal interaction learning courses or activities, which can promote positive influence among peers to reduce exposure to illegal substances.