高風險青少年非法藥物使用之風險及保護因素─以韌性觀點探究

Abstract

文獻顯示高風險青少年比一般在校少年有更高的用藥危機，但國內學者卻鮮少針對高風險青少年的用藥議題進行研究，研究方向也往往著重於青少年用藥的成因，缺乏正向觀點。因此，本研究以韌性觀點作為理論基礎，探究影響高風險青少年使用非法藥物的社區風險因素，並從個人、家庭及專業人員三個面向，檢視降低高風險青少年用藥行為相關之保護因素。 本研究採用量化研究方法，針對12-21歲的高風險青少年進行自陳式問卷調查，以立意抽樣的方式，透過大台北地區相關高風險青少年的社福機構協助轉介受訪者。研究樣本共計450人，其中有效問卷為273份。本研究主要採用多元邏輯斯蒂迴歸分析檢測解釋高風險青少年用藥的風險及保護因素，研究結果摘要如下： 一、高風險青少年非法藥物使用現況：有99位受訪者過去曾使用非法藥物，占全體有效樣本36.3%，其中過去一年未接觸任何非法藥物者，占全體用藥樣本52.5%；一年內持續使用任何一種非法藥物則占全體用藥樣本47.5%，用藥類型則以「K他命」最多，其次為「搖頭丸」。 二、高風險青少年非法藥物使用相關因素：在控制的情境下，發現年齡可以預測高風險青少年的用藥行為，但性別不具解釋力。而社區風險中的非法藥物可得性及同儕用藥行為可預測高風險青少年，但個人、家庭及專業人員各面向的保護因素則不具預測性。但針對曾經用藥的受訪者發現，在控制的情境下，個人保護因素中的拒藥自我效能對高風險青少年持續用藥行為具有預測性，而年齡、社區風險及其他保護因素則不具解釋力。整體而言，影響高風險青少年用藥行為的社區風險因素中，以非法藥物可得性及同儕用藥行為最為關鍵，保護因素難以發揮效果，但對於曾用藥的高風險青少年而言，拒藥自我效能則為能降低持續使用機率的重要保護因素。 三、根據上述研究結果，研究者針對高風險青少年的家長、青少年服務機構專業工作者，以及社會大眾與政府單位提出建議。在高風險青少年家長方面，建議家長可表達更明確的拒藥態度，及創造與高風險青少年正向休閒及同儕關係。在青少年服務機構的專業工作者方面，建議可提供高風險青少年培養健康休閒及正同儕的環境，以及訓練青少年自控力與自我效能的方案；在社會大眾及政府單位方面，則建議增強毒品防治網絡連結，確切執行三級預防策略，創造安全健康的娛樂場所環境，以及積極消弭三、四級毒品來源管道。

From the literature review, high-risk adolescents are much more vulnerable to drug use than general adolescents, but few studies examined the drug use behavior of high risk adolescents in Taiwan. In the past, many studies in western countries focused on risk factors explaining adolescents’ drug use, but there was a lack of studies trying to understand why some adolescents can say no to drugs. This study tries to, on the basis of the resilience theory, explore three aspects of protective factors, including individual, family and professional factors, to drug use of high-risk adolescents. Taking a quantitative approach, this study surveyed 12 to 21 years old high-risk adolescents using a structured questionnaire. Using the purposive sampling method, respondents from welfare agencies serving high-risk adolescents of the large area of Taipei city were selected. This study received 450 questionnaires, 273 were with complete data. In this study, logistic regression analyses were used to examine high-risk adolescent’s risk and protective factors to drug use. Findings of this study indicated that over 1/3 of respondents had ever used drug; while Ketamine was the most often used drug. Furthermore, over half of respondents that ever used drug continue using drug in the past year. The study also found that after controlled for the influence of other variables, availability of drugs and drug use of peers could explain drug use behavior of high-risk adolescents. It showed that the higher availability of drugs and the more drug use of peers would increase the probabilities of drug use among high-risk adolescents. On the other hand, self-efficacy of refusing drug could explain the continuing use of drugs among high-risk adolescents. It showed that the higher self-efficacy of refusing drug would reduce the probabilities of their drug use behavior. Implications were conclude in this study, and suggestions are recommended to high-risk adolescent’s parents, workers in social organizations serving high-risk adolescents, and communities as well as governmental agencies. It is hoped that the aforementioned agencies can make efforts to help high-risk adolescent to refuse drug, and to create save environments and refrain adolescents from accessing illegal drugs.