| Objective: To analyze of the current situation of narcotic and psychotropic drug abuse,monitoring status and monitoring needs in medical institutions in Gansu Province,explore relevant influencing factors,and construct a monitoring index system for narcotic and psychotropic drug abuse in medical institutions in Gansu Province,with a view to providing a basis for accurate monitoring of anesthetic and psychotropic drug abuse in Gansu Province.Methods:(1)Drug abuse monitoring data in Gansu Province from 2016 to 2022 were collected,and descriptive epidemiological methods were used to analyze the current situation and trends of narcotic and psychotropic drug abuse,drug of abuse parity and abuse characteristics in Gansu Province from 2016 to 2022,and multiple correspondence analysis was used to explore the influencing factors of polydrug abuse.(2)The cross-sectional research method was adopted,and 96 medical institutions in Gansu Province were selected by stratified optimal proportion sampling method to investigate the current situation.Analyzed sequentially the current situation of narcotic and psychotropic drug abuse among medical institutions in Gansu Province,and the level of drug abuse monitoring cognition among medical staff in these institutions,and used the generalized linear model to analyze the factors that influence drug abuse monitoring cognition;Then,the current state of drug abuse monitoring in medical institutions in Gansu Province was analyzed,and the factors affecting the monitoring work were analyzed by multivariate logistic regression.Finally,association rules were applied to analyze the demand for drug abuse monitoring among medical staff in Gansu Province’s medical institutions.(3)Based on the retrospective analysis of historical data and investigation of the current situation,and following the "structure-process-result" theory as well as guidelines from the US Centers for Disease Control and Prevention and the World Health Organization for evaluating public health monitoring systems,proposed a monitoring indicator system for drug abuse in medical institutions in Gansu Province.Results: 1.A total of 30,324 cases of drug abuse monitoring in Gansu Province from 2016 to 2022 were collected,including 349 reported in hospitals,4,880 reported in methadone clinics,and 25,095 reported in detention centers and drug rehabilitation centers.Among all the information on drug abuse monitoring,1032 cases of narcotic and psychotropic drug abuse were reported,with 52.51% of them being reported by hospitals and methadone clinics.2.Among the 1032 cases of narcotic drug abusers,the majority were male,married,unemployed and peasants,with a low education level of junior high school or below,and of Han nationality.The hospital reported that the average age of drug abusers was 56.52±15.30 years old,the average age of first drug abuse was51.37±15.37 years,and the average duration of drug abuse was 5.15±7.10 years.The average age and age of first abuse were higher than those reported by methadone clinics,detention centers,and drug rehabilitation centers,and the duration of abuse was lower than that reported by the other three monitoring agencies.The trend in demographic characteristics of drug abuse monitoring from 2016 to 2022 indicated a decrease in the proportion of individuals in the younger age group and an increase in the proportion of individuals in the older age group each year.The proportion of farmers has been increasing year by year.Trend analysis of demographic characteristics by gender indicated that the population of drug abusers was dominated by an increase in elderly females.3.Drugs of abuse vary by monitoring agency.The main drugs abused by medical institutions in the past 12 months were sedative-hypnotic drugs,and the main reason for the abuse was to control the disease.The main drugs abused by the methadone clinic,detention center,and drug rehabilitation center in the past 12 months were opioids and compound diphenol ester.The main reasons for abuse were to satisfy curiosity,relieve withdrawal reactions,etc.The combination of sedative and hypnotic drugs was the main source of polydrug abuse in the hospital,and there was also combined abuse of opioids and compound diphenoxylate or diazepam in other monitoring units.Age,marital status,occupation,and education level were influencing factors of abuse.4.The analysis results of monitoring data showed that the main drugs of abuse monitored by hospitals were mainly obtained from hospitals.Additionally,some of the main drugs of abuse in methadone clinics,detention centers,and drug rehabilitation centers were sourced from hospitals and pharmacies.5.The current survey surveyed a total of 96 medical institutions with 1,449 medical personnel.30.04% of clinicians reported that they had encountered suspicious patients,and 31.42% of pharmacists reported that they had encountered suspicious patients.6.The overall median score of medical staff in medical institutions in Gansu Province on drug abuse was 52.5(42.0,64.0),of which the median score of monitoring basic definition cognition was 8.0(5.0,12.0),and the median score of monitoring management cognition was 22.0(14.0,30.0),and the median cognition score of monitoring attitude was 22.5(20.0,27.5).Gender,working years,department,and hospital level were found to be influencing factors on monitoring cognition.7.In the survey on drug abuse monitoring in medical institutions,14.70% of the medical staff believed that their medical institutions had monitoring personnel,systems,and system construction in place.After multivariate logistic regression analysis,the results showed that tertiary hospitals [OR=1.438,95%CI(1.032～2.004)]were the promoting factors for the good performance of monitoring work,and general hospitals [OR=0.566,95%CI(0.349～0.919],the middle level [OR=0.538,95%CI(0.391～0.742)],and the low level [OR=0.203,95%CI(0.121～0.341)] of monitoring cognition were the influencing factors.8.The demand for monitoring the abuse of narcotic drugs showed that most medical staff choose general hospitals,psychiatric departments,full-time monitoring personnel,the combination of sentinel and routine monitoring,screening from medication records,and selecting a quarter to constitute the monitoring of narcotic drug abuse in medical institutions system.Among them,medical staff with a high degree of monitoring awareness tend to use cancer hospitals and general hospitals as monitoring institutions,and oncology departments as monitoring departments;pharmacists thought that monitoring by clinicians or pharmacists is better;in addition,system construction,funding,and information construction were needed,sharing mechanism,considering geographical population and other factors to carry out the monitoring construction of narcotic substance abuse.9.The construction of the monitoring indicator system for narcotic and psychotropic drug abuse in medical institutions in Gansu Province includes 3first-level indicators: monitoring structure,monitoring process,and monitoring results,14 second-level indicators: monitoring institutions,system construction,organizational structure,information construction,monitoring budget,education and training,monitoring objectives,monitoring content,monitoring methods,abuse diagnosis,monitoring data,quality control,epidemic trend and information release,and 54 third-level indicators.Conclusion: The population of narcotic and psychotropic drug abusers in Gansu Province is showing an increasing trend among middle-aged and elderly individuals.Medical institutions are one of the sources for narcotic and psychotropic drug abusers obtain drugs of abuse.Medical staff in Gansu Province believe that monitoring of narcotic and psychotropic drug abuse in medical institutions needs to be improved.The medical staff’s cognition of drug abuse monitoring was insufficient.Medical staff require adequate personnel,funding,technical training,and system construction in the monitoring of narcotic and psychotropic drug abuse.Therefore,it is crucial to establish and improve the monitoring indicators for narcotic and psychotropic drug abuse in medical institutions to advance the progress of drug abuse monitoring in Gansu Province. |
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