目的 了解我国强制隔离戒毒治疗人群大麻使用特征,为我国大麻禁毒政策提供参考。方法 利用2016年公安部重点城市毒品滥用规模评估项目数据,对全国30个省、自治区和直辖市的55个省会城市和重点城市的强制隔离戒毒治疗人群中大麻使用者社会人口学、毒品使用特征进行描述性分析,采用χ²检验、Fisher精确检验和Kruskal-Wallis秩和检验比较不同人群中大麻、海洛因、合成类毒品和混合毒品使用率的差异,以及大麻使用者中多药使用情况及地区间的差异。 结果 共纳入强制隔离戒毒治疗人员25 366人,大麻使用率为2.2%(546/25 366)。在大麻使用人群中,男性占83.5%,少数民族占41.0%,初中及以上学历占30.8%,无业人员占44.1%,平均年龄为(33.3±8.2)岁,平均首次吸毒年龄为(24.8±7.7)岁,首次吸毒到首次强制隔离戒毒的平均间隔时间为(5.4±4.6)年。35岁及以下、少数民族、在职、新疆的强制隔离戒毒人群大麻使用率较高。使用大麻的546人中,91.4%人存在多药使用情况,13.6%只合用海洛因,42.1%只合用合成类毒品,35.7%混合使用海洛因和合成类毒品。49.6%的大麻使用者集中在新疆维吾尔族自治区、江苏和上海三个地区。新疆大麻使用者中少数民族和初中及以下人群所占比例较高,有79.6%大麻使用者合用海洛因;江浙沪地区大麻使用者中汉族和高中及以上人群所占比例较高,有92.7%大麻使用者合用甲基苯丙胺。结论 我国强制隔离戒毒治疗人群中大麻使用率较监测吸毒人群中的大麻使用率高,并且存在地域聚集性和较高的多药使用现象,提示宜针对不同地区和人群,加强对大麻使用情况的监测,加大对大麻的管控力度,制定符合我国国情的禁毒政策。

Objective: To explore the epidemic situation of cannabis use among drug users with compulsory detained detoxification treatment in China.Methods: Using the data from the Drug Abuse Population Estimation in the Key Cities of the Ministry of Public Security, we analyzed the sociodemographic characteristics and substance use of cannabis abusers with compulsory detained detoxification treatment in 55 provincial capital cities and key cities of China. Chi-square test, Fisher exact test and Kruskal-Wallis rank sum test were used to compare the prevalence of cannabis, heroin, synthetic and mixed drug use among patients with detoxification treatment, as well as the differences in polydrug use and areas among cannabis users.Results: In the study, 25 366 drug users with compulsory detained detoxification treatment were recruited, of whom 2.2% (546/25 366) used cannabis in the previous year before the treatment. The proportion of males was 83.5%, and the proportion of ethnic minorities was 41.0%. Those who received junior high school education or above accounted for 30.8%, and the unemployed accounted for 44.1%. The average age was (33.3±8.2) years, the average age of beginning drug use was (24.8±7.7) years, and the average duration between the first drug abuse and first detoxification treatment was (5.4±4.6) years. The prevalence of cannabis use was higher among those drug users who were 35-year-old and younger, ethnic minorities, employees and residents in Xinjiang. Of the cannabis users, 91.4% used polydrug, 13.6% combined with heroin alone, 42.1% combined with synthetic drugs alone and 35.7% combined with both of heroin and synthetic drugs. Of the cannabis users, 49.6% came from 3 regions: Xinjiang Uygur Autonomous Region, Jiangsu Province and Shanghai City. The cannabis users in Xinjiang had a high proportion of ethnic minorities who received junior high school education and below. Moreover, 79.6% of them combined cannabis use with heroin. The cannabis users in Jiangsu, Zhejiang and Shanghai areas had a higher proportion of ethnic Han who received better education (high school and above). Moreover, 92.7% of them combined cannabis use with methamphe-tamine.Conclusion: The prevalence of cannabis use among the population with compulsory detained detoxification treatment is higher than that among drug users under surveillance, but there are obvious regional cluster effect and high possibility of polydrug abuse. Thus, it’s important to strengthen the monitoring of cannabis use, to increase the control of cannabis and to formulate China’s anti-cannabis policy among different population.