Mindset Feature




	Youth Substance Abuse Shows Dramatic Increase Introduction Substance abuse generally refers to the inappropriate use of prescribed or illicit drugs over a period of time, despite the presence of physical, psychological or social complications. The statistics of substance abusers from the Central Registry of Drug Abuse revealed that the prevalence of substance abuse among young people (age under 21) increased dramatically over the past five years. In addition, the age of psychoactive substance abusers in first contact with the psychoactive substances is on a decreasing trend. The effect of psychoactive substance abuse on young people is particularly adverse because the developing brain in young people is more vulnerable to the detrimental effects of psychoactive substances. Reasons of psychoactive substance abuse in young people There are a wide range of risk factors which lead to psychoactive substance abuse of the youth: Environmental Lack of warmth from family; � Stress from transitions in the development stages; � Social deprivation. Individual Lack of appropriate role model during development; � Poor coping skills for stress; Problems in development of personal identity; � Problems in mood regulation and impulse control; � Lack of satisfaction from daily activities. Pharmacological The craving and withdrawal symptoms. Common psychoactive substances There are a member of common psychoactive substances available to young people: Ketamine A kind of dissociative anaesthetic agent used in veterinary surgery or paediatric procedures; � Depending on the dosage, it could result in confusion, in-coordination of limbs, analgesia, mood swings and psychosis; � Long term neuro-psychiatric complications include poor memory, depressive mood, persistent psychotic symptoms; � Physical complications include painful urination, urinary frequency, damage in kidney, epigastric pain. Stimulants These include methamphetamine (Ice), MDMA (Ecstasy) and cocaine; � Neuro-psychiatric complications include psychosis, mood disorder and poor memory; � Physical complications include marked increase in blood pressure and heart rate, heart attack, stroke, hyperthermia, acute renal failure, etc. Cough mixture Physical complications include constipation, tooth decay; � Neuro-psychiatric complications include psychosis and poor memory. Strategies against psychoactive substance abuse in youth At the primary level, we should increase the awareness among young people about the characteristics and complications relating to the abuse of psychoactive substance. Support from family and school is also highly essential, and young people should be encouraged to develop healthy lifestyles, which will help improve the skills in coping with stress and manage moods and emotions. In addition, it would be helpful if family members, friends and primary health care professionals can detect any symptoms or problems at an early stage. Finding out the motivation for the person to quit drug use is the next step. Brief interventions should be undertaken for those with mild problems. For those with serious physical and psychiatric complications, there should be multidisciplinary assessment and treatment. Interventions should be directed to prevent relapse, and above all, a change in one's lifestyle may be the most fundamental cure. Further information is available from http://www.ha.org.hk/kch/eng/education/edu-index.html. This article is contributed by Dr Cheung Wai Him, Associate Consultant, Substance Abuse Assessment Unit, Kwai Chung Hospital. 青少年濫藥問題日趨嚴重引言濫用藥物一般是指長期不適當地服用處方或違禁藥物，而無視濫藥對身心或社會構成的影響。根據藥物濫用資料中央檔案室有關濫藥者的統計數據顯示，過去五年二十一歲以下的青少年吸食危害精神毒品的情況激增。此外，首次接觸危害精神毒品的人士的年齡呈下降趨勢。吸食危害精神毒品對青少年的影響甚為嚴重，因為他們的腦部仍處於發育階段，較易受危害精神毒品影響以致腦部受損。青少年濫用精神藥物的原因導致青少年吸食危害精神毒品的成因眾多，其中包括：環境因素缺乏家庭溫暖； � 踏入另一個成長階段所面對的壓力； � 缺乏社會資源。個人因素成長期間缺乏合適的模仿對象； � 處理壓力的技巧不足； � 個人認知發展方面出現問題； � 在調節情緒和控制衝動方面出現問題； � 日常生活缺乏滿足感。藥理因素心癮及戒斷症狀。一般精神藥物青少年較常接觸的一般精神藥物包括：氯胺酮在獸醫手術或兒科醫療程序中使用的一種分離性麻醉劑； � 視乎劑量而定，分別可引致精神紊亂、肢體動作不協調、痛覺缺失、情緒波動及精神病； � 神經精神病學的長期併發症包括記憶力衰退、抑鬱、持續精神錯亂症狀； � 身體併發症包括小便疼痛、尿頻、腎臟受損、上腹痛。興奮劑包括甲基安非他明（冰）、亞甲二氧基甲基安非他明（Fing頭丸）及可卡因； � 神經精神病學的併發症包括精神病、情緒障礙及記憶力衰退； � 身體併發症包括血壓顯著上升、心跳明顯加速、心臟病、中風、體溫上升、急性腎衰竭等。咳藥水身體併發症包括便秘、蛀牙； � 神經精神病學的併發症包括精神病及記憶力衰退。青少年濫用精神藥物問題的對策首先，我們應讓青少年更了解濫用精神藥物的特徵及併發症。家人和校方的支持亦至關重要。此外，鼓勵青少年養成健康的生活習慣，亦有助他們更懂得紓緩壓力和管理個人情感與情緒。此外，親友和前線醫護人員越早發現任何症狀或問題，便越能及早解決有關問題。下一步就是要找出戒毒的原動力。濫藥情況輕微者可施以簡單治療。至於生理及心理均已出現嚴重狀況的濫藥者則須接受多方面的評估與治療，患者必須尋求專業治療以免問題復發。然而，改變個人生活習慣終究是最治本的方法。有關詳細資料可瀏覽http://www.ha.org.hk/kch/chi/education/edu-index.html。本文由葵涌醫院藥物誤用評估中心副顧問張偉謙醫生提供。