我国药物滥用流行特征,现况与药物滥用预防问题探讨

我国药物滥用流行特征、现况与药物滥用预防问题探讨刘志民，蔡志基（北京医科大学中国药物依赖性研究所北京邮编１０００８３）药物滥用流行学研究表明，药物滥用（ｄｒｕｇａｂｕｓｅ，俗称吸毒）在人群中的发生和流行受到包括政治、文化、经济和在某一社会环境中生活的...     

反思毒品预防教育:基于药物滥用预防体系的构建

我国禁毒工作中长期使用"毒品预防"一词,在此理念影响下逐渐产生了教育的负向功能,导致了毒品认知混乱、教育方式恐吓化、预防康复理念冲突以及教育主体单一化等问题.基于当前毒品预防教育工作中的现实困境,应强调"药物滥用预防"的理念,构建全方位预防观,调整预防内容和方式,构建药物滥用预防的评估体系,加强药物滥用预防制度保障,以...     

昆明市一所中学药物滥用及HIV／ADIS预防研究

在昆明市一所中学开展药物滥用及ＨＩＶ／ＡＤＩＳ预防活动，以该校初中部两个斑的学生为预防活动对象，预防活动以信息传播，抵制技能训练，情感教育及个人社会生活技能训练为主，每周活动１次，每次４５ｍｉｎ，共３６例，持续３个学期，采用问卷调查评估，结果表明，预防活动能增加预防对象的相关知识和技能，并在一定程度上改变预防对象对药物滥用及ＨＩＶ／ＡＤＩＳ的负性态度和行为，并对今后学校进行药物滥用的预防方式提出了     

英国中小学校药物滥用预防教育:政策、实践与研究

药物滥用是当今英国非常严重的一个社会问题。尽管在社会各界的努力下 ,其治理工作取得了一定的成效 ,但药物滥用率仍然居高不下 ,难以控制 ［１］。许多年轻人滥用药物 ,而且滥用率在过去１０ａ里有了明显的增加。一项对９４９６名中小学生进行的药物滥用调查表明 ,在苏格兰 ,中学一年级到四年级的学生中有１／４曾经至少一次尝试过非法药物 ［２］。其种类主要为大麻、有机溶剂、苯丙胺类、止痛剂以及镇静催眠药等。药物滥用已严重地威胁着人们的健康 ,并且由于与之有关的犯罪活动 ,也已严重地威胁到街道及社区的安全 ［１］。在控制药物…     

新疆乌鲁木齐地区药物滥用情况分析

目的··:了解新疆地区药物滥用情况 ,为该地区的禁毒、戒毒工作提出建议。方法··:对乌鲁木齐地区强制戒毒的1281例药物滥用者进行社会人口学特征、吸毒原因的问卷调查。结果··:1281例全部为阿片类滥用者 ,有25.21 %同时滥用大麻 ,21.70 %同时滥用三唑仑 ,11.79 %同时滥用地西泮 ;男性占86.26%;30a以下的滥用者占77.52 % ;其中85.58 %的女性滥用者的年龄在30a以下 ;初中以下文化程度占78.20%;无业、个体和农民占69.74 % ;个体、无业、单亲、重组家庭及孤儿占73.22 %;药物滥用的主要原因是好奇和逆反心理。结论··:男性、30a以下、无正当职业、文化程度低、家庭和周围环境欠佳者为药物滥用的易感人群 ,提出我国的禁毒、戒毒工作中应把重点 ,特别是药物滥用的预防工作重点放在该人群。     

青少年药物滥用和预防教育现状

"物质滥用(substance abuse)"是一个全球范围内的重大公共卫生问题[1]。物质即指麻醉药品、精神活性物质,是指主要作用于中枢神经系统,从而影响认知、情绪、意识等心理过程的化学物质。因为麻醉药和部分精神活性物质在一定条件下可以用于临床,     

药物滥用的预防

近年来在我国早已绝迹的毒品滥用问题又在我国某些省(区)死灰复燃。全国滥用人数已由1991年的7万人增加到1992年的25万人。经北京医科大学中国药物依赖性研究所等单位调查，滥用者社会人口学特征为男性居多，以青年和青少年为主，25a以下的占65％，初中和初中文化程度以下者占绝大多数，多为个体商人和无业人员。吸用的毒品为阿片、海洛因。据了解目前吸用的是高纯度海洛因．     

昆明市一所中学药物滥用及HIV／AIDS预防研究

在昆明市一所中学开展药物滥用及ＨＩＶ／ＡＩＤＳ预防活动。以该校初中部两个班（共８７人）的学生为预防活动对象。预防活动以信息传播、抵制技能训练、情感教育及个人社会生活技能训练为主，每周活动１次，每次４５ｍｉｎ，共３６次。持续３个学期。采用问卷调查评估。结果表明，预防活动能增加预防对象的相关知识和技能，并在一定程度上改变预防对象对药物滥用及ＨＩＶ／ＡＩＤＳ的负性态度和行为。并对今后学校进行药物滥用的预防方式提出了建议。     

药物滥用预防与科学、文化和伦理道德问题的关联(英文)

近年来在脑与行为领域的科学进展和发现已经革新了我们对于物质滥用及其对人体思维和情绪作用的知识。与此同时,针对促进药物滥用和成瘾发展的人类行为和环境的大量心理学和社会文化方面的研究也在展开。文化因素也被认为在世界不同地区成瘾行为的发展和上升中起重要作用。要采取有效的策略解决全球非法药物滥用与成瘾问题,我们需要一种整合和统一的视角,这种视角不仅包括科学,还应包括文化,伦理道德和精神等社会组成部分。药物滥用是一个涉及多方面的问题。它可以是生物因素和基因缺陷的结果,也可以是由于社会影响,药物的易获得性,文化压力等因素导致的习惯性行为。因此,针对药物滥用或成瘾者进行预防、治疗和康复的任何成功的计划都应该考虑到多方面的因素。科学研究在解释分子生物学、脑影像学等在药物滥用形成耐受和依赖的发展过程中的重要性方面已经取得了一定进展,该领域的研究还阐释了基因发挥作用并将成瘾的特性传递给后代的途径。然而科学对于药物滥用预防的贡献是有限的,因为这是一个需要综合心理干预和咨询的领域。文化在指导人们的态度和形成成瘾或戒断的潜在动机中发挥了核心作用。个体的戒断和康复部分依赖于文化环境。事实上,对非法药物的界定在不同文化中也各不相同。每个社会都建立了控制人们接触药物和酒精的行为规范。因此,在对药物滥用多角度、综合的预防和干预措施中,理解不同的文化期待、态度和行为规范是至关重要的。伦理道德和精神文明也是药物滥用预防中重要的因素。非治疗用的处方药物就是药物滥用领域中存在的伦理问题。另外,关于非法药物滥用的立法问题也在各个国家引起了严重的争议。伦理和科学不是互斥的关系,两者都在为大多数人的利益努力寻求真理。统揽科学、文化、伦理道德和精神文明对于预防药物滥用和成瘾康复有重要的意义。主要文明体系的和睦关系将带来更为有效的策略,以克服由于药物滥用问题蔓延导致的全球性危机。     

基于QbD理念的药品质量分析研究新概念

本文阐述质量源于设计理念在药品质量评价分析中的应用基础,结合2010年全国评价性抽验的成效及特点,诠释质量源于设计理念在药品质量评价分析中的应用实践,展望质量源于设计理念在药品抽验工作计划、质量分析、质量再评价研究中的应用前景。     

A review of drug prevention system development in Romania and its impact on youth drug consumption trends, 1995–2005

Issues. A tremendous growth occurred in the reported drug use and abuse in Romania from 1995 to 1999. Lack of concern by government and little policy attention contributed to the surprising delay of drug policy and drug prevention system development. General public stigmatize drug users and drug consumption is considered a matter of personal fault and responsibility. There is some but not sufficient research and evaluation on drug use, abuse problem. Approach. Drug use, abuse and prevention are discussed from research‐based, user‐focused and prevention system development perspectives. Prevalence and trends of drug use, abuse in the past decade (1995–2005) are summarized. Prevention issues are discussed based on research data from adolescents, parents and teachers. The Romanian primary drug prevention system has been evaluated based on our experiences in drug use prevention activities carried out in schools and recreational environments. Key Findings. Public and scientific perspectives on drug consumption in Romania, between 1995 and 1999, were dominated by an idealistic, non‐realistic perception. Since 1995, drug use among adolescents increased almost four times in less than 4 years. The first law against drug traffic and consumption was issued only in 2000. Now primary drug prevention strategies are in action, but in general they are lacking standard evaluation procedures. Implications/Conclusion. Conclusions are drafted for new perspectives in prevention activities. More long‐term, user‐focused, demand‐centred prevention activities should be carried out in more and more diversified settings and evaluation should be thoroughly considered.[Dégi CL. A review of drug prevention system development in Romania and its impact on youth drug consumption trends, 1995–2005. Drug Alcohol Rev 2009;28:419–425]     

应用Westgard多规则理论评估万古霉素血药浓度监测的室内质控

目的:探讨自制万古霉素质控血浆在血药浓度监测中的稳定性,应用Westgard多规则理论评估万古霉素血药浓度监测(TDM)的室内质量控制。方法:取万古霉素标准品12.20mg,50%甲醇溶解后加入空白血浆基质液,制备质量浓度分别为4.88,24.40,40.02μg·mL-1的万古霉素质控血浆,在连续25个工作日内对75个低、中、高质控浓度进行监测,绘制LeveyJennings质控图和Z-分数质控图,采用Westgard多规则进行质量评估。结果:万古霉素低、中、高室内质控的日内和日间RSD分别为0.59%～0.86%、3.90%～5.67%,回收率分别为98.90%～102.11%、102.93%～106.91%,符合《中国药典》2015年版(四部)生物样品测定的要求;绘制的质控图显示低、中、高浓度质控血浆均未出现失控。结论:自制万古霉素质控血浆操作方法简单、成本低、结果可靠,可以作为实验室日常质量控制;利用室内质控评价体系对TDM监测数据进行评估,可以保证血药浓度测定的准确性、可靠性,从而为临床合理化给药提供准确信息。     

Five typologies of alcohol and drug prevention programmes. A qualitative review of the content of alcohol and drug prevention programmes targeting adolescents

Adolescents exhibit a high rate of use of alcohol and illicit drugs. Effect studies rarely describe the actual content of the interventions in detail. Less is known about what was actually done in the prevention than about their effects.

Aim: This study is a review study grouping the qualitatively different content components of the various approaches into five categories. Methods: A systematic literature review from Western countries on the topic of school-based interventions and prevention initiatives targeting young people aged 12–20. A modified version of the narrative synthesis approach is used for analysis. The sample consisted of 33 peer-reviewed articles published between January 2010 and December 2014. Findings: Five categories of intervention and prevention programmes were identified: ‘Information-based or testing-based primary prevention approaches’, ‘Primary prevention approaches incorporating skill-training components’, ‘Universal or primary prevention approaches that include family components’, ‘Targeted approaches incorporating skill-training components’, and ‘Approaches incorporating digital features’. Conclusion: Only four studies that employed any form of targeting or profiling of the subjects prior to the delivery of the prevention intervention or initiative were identified. The skewness towards primary prevention skill-training approaches should be addressed, given the diverse consumption patterns among adolescents.     

浅谈西药片剂质量标准

本文结合日常的药品监督检验及药品注册标准复核工作中发现的问题,就西药片剂的命名及质量标准中相关检验问题进行探讨,为片剂质量标准的科学、合理、规范的制定和修订提供参考。     

The creation of evidence in 'evidence-based' drug prevention: a critique of the Strengthening Families Program Plus Life Skills Training evaluation

School-based curricula have become a mainstay of drug prevention policy in the United States and are increasing in popularity in other parts of the world. The promotion and dissemination of these interventions has been driven in large part by the creation of lists of programmes which, it is claimed, are grounded in scientific evidence demonstrating their effectiveness. Recently concerns have been raised about the data analysis and presentation practices used in evaluations of a number of programmes that appear on these lists. Here we examine a series of papers from an evaluation of an intervention that combined the Strengthening Families Program 10 - 14 and Life Skills Training Program, each of which is among the most widely advocated universal drug prevention programmes. The data analysis and presentation practices employed in the evaluation of this combined programme include one-tailed significance testing, alpha levels of 0.10, changes in outcome variables across publications and use of the post-test data as the baseline when assessing change over time. Taken together, these practices severely limit the claims that can be made about the results presented in the evaluation. Specifically, we believe that far from supporting the evaluators' claims concerning the rigour of the findings and their generalisability and public health significance, the results are very fragile, of little practical significance and quite possibly analysis-dependent. [Gorman DM, Conde E, Huber JC Jr. The creation of evidence in 'evidence-based' drug prevention: a critique of the Strengthening Families Program Plus Life Skills Training evaluation. Drug Alcohol Rev 2007;26:585 - 593]     

治疗药物监测的全程化质量控制

目的：为了提高治疗药物监测的结果，本文剖析了治疗药物监测的各个环节，提出了可能使监测结果变化的原因并运用全程化质量控制提出解决的办法。方法：针对分析前、分析中、分析后的主要环节可能产生血药浓度变化的因素进行分析。结果：对变化的因素提出全程化质量控制的要求，进行全程监测，提高血药浓度监测的准确度。结论：除了血药浓度的分析中这一步骤，分析前、分析后的质量控制对于治疗药物监测同样重要。     

品管圈在提高某院PIVAS药品调配残留达标率的应用研究

目的:通过运用品管圈的质量管理方法,规范静脉用药集中调配操作,提高静脉用药调配中心(PIVAS)药品调配残留达标率,提高静脉输液调配质量。方法:首先建立品管圈,设立药品调配残留量限度标准,采用减重称量法、体积测量法测定药品调配残留量。然后通过现状把握、要因分析、对策拟定与实施、效果确认、标准化、检讨与改进等品管圈基本步骤提高药品调配残留达标率。结果:药品调配残留量检测方法可靠,对策实施有效,药品调配残留达标率由改善前的38.6%提升到改善后的83.70%(P<0.05),目标达成率106.87%。结论:药品调配残留量的测定方法成本费用低、操作简单,可有效测定药品调配残留达标率。应用品管圈质量管理方法可有效改善药品调配残留达标率,而且可以激发圈员学习的主动性和运用品管圈工具解决临床实际问题的能力。     

药品质量标准制订的QbD理念初探

本文介绍了基于质量源于设计（QbD）理念的药品质量标准制订过程,通过获取有用的与药品质量有关的信息和药品本身蕴藏着的丰富知识,采用科学的风险评估、寻找关键的质量属性、进行合理的空间设计,制订可行的达到全面认识的质量标准。为我国药品质量标准的制订提供参考。     

药品质量标准制订的QbD理念初探

本文介绍了基于质量源于设计(QbD)理念的药品质量标准制订过程,通过获取有用的与药品质量有关的信息和药品本身蕴藏着的丰富知识,采用科学的风险评估、寻找关键的质量属性、进行合理的空间设计,制订可行的达到全面认识的质量标准.为我国药品质量标准的制订提供参考.