安非他命之濫用——從醫學及心理學觀點之探討

AMPHETAMINE ABUSE: MEDICAL AND PSYCHOLOGICAL VIEWS

安非他命是一合成中樞神經興奮劑，具有促進中樞神經多巴安系統亢進之作用，醫療用途曾使用於嗜睡症、兒童過度活動及肥胖症，因其具有嚴重之戒斷症狀及高的成癮性；藥物濫用者在精神科住院之比率逐年增加，民國70年佔全年住院之3.7%，民國78年及79年分別佔13.7及14%，而民國78年起，更見到因安非他命引起精神病症狀而住院者，雖然目前在國內雖已將安非他命歸類於非法之藥物，但仍被廣泛的濫用。本文將討論安非他命引起之急性精神症狀及心理因素，包括：（一）一位是安非他命引起幻覺，由聽幻覺命令而服毒自殺的個案。（二）精神科急診及門診中，因安非他命引起之疾病（N=25）而求助者之臨床症狀敍述性研究。國內目前安非他命之濫用除了醫學及心理學外，仍待針對生物－心理－社會－文化等因素間之相互關係進一步研究探討，以便對防治計劃更能落實，確實達到國人生理及心理健康。

Amphetamine, a synthetic central nervous system stimulant, depleted much dopamine from presynaptic dopaminergic neurons and was used to treat narcolepsy, hyperactivity child, and obesity medically. There were several severe withdrawal symptoms and signs reported after usage and also high potential for addictions psychologically and physiologically. Psychiatric hospitalizations of substance use disorders were increasing annually from 3.7% (1981) to 13.7% (1989) and 14% (1990) respectively. Nowadays amphetamine is absolute restricted by health administration. Multiple factors including medical, psychological, social, and cultural factors make these abnormal substance use behaviors more complicated . This paper will discuss about medical and psychological v1ews of amphetamine abuse including : (1)A case report of amphetamine related death: The patient suffers from amphetamine induced auditory hallucination that voice commenting makes her suicide with acute poisoning. (2)Differential diagnosis of acute psychotic state in psychiatric clinics: Amphetamine induced psychiatric problems (N=25) will describe including major psychotic and physical symptoms and signs, precipitating factors, underlying causes of abuse and outcome. Further investigations of amphetamine abuse including bio-psycho-socio-culture factors should carry out for preventing substance abuse and healthy care systems.