抄録
Currently in Taiwan, the illicit substances used include sedatives, hypnotics, solvents, heroin, amphetamines, and hallucinogens (MDMA, ketamine, marijuana, and LSD). The so-called club or pub drugs include sedatives, hypnotics, solvents, cocaine, amphetamines, and hallucinogens. All these drugs are popular in the adolescents, especially hallucinogens, sedatives and their mixtures. Since late 1990s, their epidemics in many countries/regions, Taiwan as well, are related to problems of globalization, and further wide-spread by media, websites, pubs/parties.
The acute effects of hallucinogens or sedatives are less toxic than narcotics or stimulants. Therefore, cases of hallucinogen or sedatives seemed seldom found clinically. However, cases of acute phenyl alkylamines (MDMA, PMMA, mephedrone, etc) and gamma-hydroxybutyric acid poisoning were sometimes encountered. Nevertheless, cases of ketamine induced uropathy and nitrous oxide induced neuropathy among the young users were increasingly found in these couple years. Besides, these drugs provide as “gate drugs” due to their variability and changeable ingredients and forms of pills, and more choice for the youth. All these raised important public health issues.
Primary care clinicians may encounter substance abusers often but may not always recognize the direct drug effects, their complications, withdrawals, and even its social consequences, including accidents, suicide, homicide, drug facilitated sexual assaults, etc. Moreover, psychological consequences of drug abuse, such as aggressive behavior, suicidal ideation, or hallucinosis, or psychiatric co-morbidities often found in drug users. Patients with these presentations should be carefully related to drug use. Frequently, it is urgent and difficult to tell what conditions indicate the evidence of drug use, and which complications need to be suspected in known drug users. Moreover, it’s hard to deal with adolescents with substance abuse, due to less frequent use, less toxic substance. However, it’s important to detect, educate and treat adolescents with substance abuse problems as earlier as possible.
