觸發不同用藥類型海洛因成癮者復發決意之生活事件比較研究

Study on Comparison of the Critical Life Events Which Can Enact the Heroin Abusers' Relapse Intention among Single-Drug-Use Group, Double-Drug-Use Group, and Poly-Drug-Use Group

林瑞欽(Rueih-Chin Lin) ； 鄭添成(Victor Cheng) ； 李易蓁(I-Chen Lee)

《玄奘社會科學學報》 11期 (2013/05) Pp. 145-187

摘要

本研究在探究觸發海洛因成癮者復發決意的情境與生活事件、與其強度。2005年六月以前仍在台北監獄、台中監獄、雲林監獄、嘉義監獄、台南監獄、高雄監獄；桃園女子監獄、台中女子監獄、高雄女子監獄等接受矯治之受刑人為對象，以立意取樣方式，抽選入監前半年主要用藥為海洛因之男、女成癮者1500名（男=900名、女=600名），進行以自編之「海洛因成癮行為問卷」調查，回收率為100%。然經刪除漏答、作答有明顯傾向、或亂答傾向者後，共取得有效問卷900份（男=500名、女=400名），有效問卷回收率為60%（男=55.6%、女=44.4%）。結果摘述如下：1.受試者平均年齡為33.97歲、近八成為國高中程度；已婚、穩定家庭狀態者有21.6%；78.2%之工作狀況不穩定；吸毒前職業以勞力工作為主（52.3%）；入監前職業亦然（64.7%）。2.多重用藥者顯著比單一與雙重用藥者較早施用管制藥物、有較多的用藥性伴侶數；而女又比男較早施用管制藥物、有較多的用藥性伴侶數；以靜脈注射施用海洛因為主（男=68.8%、女=77.3%），吸食為次（男=38%、女=34%%）；停藥間隔以未滿一年者最多（男=54%、女=55.3%）、持續用藥其間以滿三個月以上至未滿二年為最多（男=69.8%、女=54%）；海洛因成癮者最普遍曾經施用、連續使用三個月、與合併使用的管制藥物為安非他命、大麻、FM2、K他命、與搖頭丸。3.較多女性海洛因濫用者表示「無法用藥時會抽更多香煙；有較多男性「想用藥時無法找到海洛因會感到難受」。整體而言，海洛因濫用者約有四成至七成的人存有用藥渴求。4.整體而言，在處於觸發情境與生活危機時，被觸發之復發決意男性比女性強；男性較易受工作與經濟適應、暴露與接觸用藥情境、正負面情緒狀態、感官追求、以及刑事司法判決結果影響而觸發復發決意；女性較易受配偶、伴侶用藥或外遇、家庭衝突而再度用藥。5.刑事司法判決結果、家庭互動困擾、暴露於人際衝突、與暴露用藥社會互動、個人生活或情緒適應等容易觸發男女海洛因濫用者之復發決意。女多重用藥者顯著比單一與雙重用藥者更容易被處於用藥情境與生活危機觸發復發決意，男性則較不受其用藥類型之影響。家庭衝突、負面情緒、感官尋求、與毒品接觸等情境與生活事件組型觸發復發決意愈強，則其用藥渴求將愈強。上述發現意謂著海洛因成癮者之戒癮所需發展之復發預防教育，不僅需考量人際溝通、情緒管理、生活壓力因應訓練，尚需教導拒絕毒品以及斷絕與毒友來往之自我決斷力。

關鍵字

觸發復發決意危機 ； 持續用藥階段 ； 海洛因濫用 ； 多重用藥

並列摘要

The primary purposes was to investigate the differences in the heroin abusers' relapse intention enacted by those critical life events among the single-drug use group, the double-drug use group, and the poly-drugs use group in Taiwan. 900 male and 600 female heroin abusers who were just enter the prison for half years, and they have been purposive sampling from six by questionnaires had been collected and analyses. The main findings are as the followings: 1. The poly-drug-use group are significantly earlier use illicit drugs, have more sexual partner who are use drugs, than the single-and double-drug-use groups. Most of subjects are vascular inject, female have a higher rate than male. 2. Male abusers have stronger intention of relapse than female abusers in their life crisis. Male abusers are more easily enacted by job and economic stresses, exposure in that drug relevant situation, positive and negative emotion, sensation seeking, and their justice sentence. Female abusers are more easily enacted by family conflicts partner abuse drugs, and their partner have affaire with other women. 3. For female abusers' relapse intention in the poly-drug-use group are more easily enacted by exposure in drug use situation and life crisis than those abusers in the single- and double-drugs-use groups. However, no significant differences in male abusers' relapse intention that enacted by those life critical events have been found among the single-drug-use group, the double-drugs-use group, and the poly-drugs-use group. 4. When their relapse intention enacted by those life events in family conflict, negative emotion, sensation seeking, and exposure in drug use are more strong, their craving are getting higher. The implications of this study on the education of relapse prevention for the treatment of heroin abstinence have been further discussed. Those skills in interpersonal communication, emotion management, life stress coping, and self-assertiveness need to involve in the relapse prevention program.

並列關鍵字

Heroin abusers ； critical life events ； relapse intention