合成卡西酮類毒品濫用情形與生理危害

Synthetic Cathinone: an Emerging Drug of Abuse, Its Pharmacology and Toxicology

近年來全球新興影響精神物質（new psychoactive substances, NPS）大量的出現，並在全球毒品市場快速成長，根據聯合國毒品暨犯罪問題辦公室於2017年所公布的年度世界毒品報告中，顯示截至2017年12月底，全球已有803種NPS，而依據衛生福利部食品藥物管理署統計2008至2017年底，在我國出現的130種NPS，合成卡西酮就佔有42種，是檢出最多的NPS種類。卡西酮是巧茶葉中的一種單胺類生物鹼，具有中樞神經興奮作用；藉由化學合成方法所製造出的合成卡西酮，其作用效果往往比天然的卡西酮更強，對人體危害也更大。由於其外觀多呈現晶體樣態與市售沐浴鹽類似，因此也被稱為「浴鹽」類毒品。此類毒品具有類似安非他命、搖頭丸的作用，但是實際的藥理作用仍然不明。目前已知使用合成卡西酮化合物會引起胸痛、心搏過速、高血壓、體溫升高、肌躍症、低血鉀、瞳孔放大和視力模糊；其對中樞神經系統的主要影響則與安非他命類興奮劑的作用相似，會造成急性精神病、狂躁症、偏執、好鬥行為和妄想。近來相關單位也常常發現合成卡西酮類毒品出現在混合毒品咖啡包、奶茶包中。這篇綜論期望能正確讓國人了解，合成卡西酮類毒品目前濫用情形與其對人體之危害。 In recent years, there has been a large increase in the number of new psychoactive substances (NPS) abused and a cumulative total of 803 different NPS reported till 2017 worldwide. One major class of NPS is the synthetic cathinone, which are related to the parent compound cathinone, one of the psychoactive substances in khat (Catha edulis). Synthetic cathinone is much stronger than the natural product and more dangerous. They are white or brown crystal-like powder and thus marketed with the brand name ＂bath salts＂ in the street. These compounds are claimed to have the effects similar to those of amphetamine or MDMA (ecstasy).The use of synthetic cathinone is often linked to health problems; however, their detailed pharmacology is still unclear. To date, we know that using synthetic cathinone compounds can induce chest pain, tachycardia, hypertension, hyperthermia, myoclonus, hypokalemia, mydriasis, and blurred vision. The major effects of synthetic cathinone on the central nervous system are acute psychosis, mania, paranoia, combative behavior and delusions, similar to the effects of amphetamine-type stimulants. Synthetic cathinone users have frequently been hospitalized with severe intoxications. Today, synthetic cathinone is often found in mixture of emerging drug of abuse in Taiwan. The purpose of this review is to provide updated medical points and abuse status on synthetic cathinone for the public.