甲基安非他命導致的身體和精神傷害及死亡

Methamphetamine-Related Physical and Mental Harms, and Mortality

10.6134/tjfm.2017.0901.01

郭千哲(Chian-Jue Kuo)；陳為堅(Wei J. Chen)；陳喬琪(Chiao-Chicy Chen)；楊添圍(Tien-Wei Yang)

甲基安非他命 ； 犯罪行為 ； 傷害 ； 自殺 ； 死亡 ； Methamphetamine ； Criminal Behavior ； Mental Harm ； Suicide ； Mortality

台灣法醫學誌

9卷1期（2017 / 06 / 01）

1 - 10

繁體中文

1990年起，甲基安非他命再度盛行，甲基安非他命已變成世上濫用最快的非法藥物，並會導致犯罪行為、身體和精神傷害。在這些危害中，死亡是極端嚴重的後果。由文獻顯示，甲基安非他命使用者比其他藥物有更多的犯罪行為，其可能發生在中毒時期，亦可發生在精神病狀態，其犯罪將使司法系統負擔重。個案需以醫療照顧；而必要時，若有自傷或傷人之虞，可依精神衛生法啟動強制住院程序而住院。甲基安非他命將導致身體及精神方面的傷害。其中，身體傷害包括毒性、心臟血管、腦血管病變及血行性病毒感染等。而精神方面的傷害包括甲基安非他命精神病、憂鬱、自殺、暴力行為。此外，濫用者容易有社會心理壓力，如人際關係缺損或失業等。依吾人先前以世代族群研究，藉由追蹤其死亡預後，其中2/3左右死於非自然死亡，而1/3死於自然死亡。推測自然死亡與身體傷害較有相關，非自然死亡與精神傷害較有相關，即與腦部的傷害有關。而此研究的死因分布以非自然死亡之比例比自然死亡要高，推測甲基安非他命所導致的傷害以腦部較高。本回顧論文系統化整理探討甲基安非他命相關的犯罪行為、身體和精神傷害及死亡；預期能提供法醫學物質成癮及臨床照護之重要參考。

The renewed popularity of methamphetamine has been shown since 1990s. Its abuse has become one of the fastest-growing illicit drugs in the world and results in high risk of criminal behavior, physical and mental harms. Among the harms, mortality is the most serious consequence. Relative to other drug users, methamphetamine users had more criminal behaviors which could happen in the state of intoxication or psychosis due to long-term use. The crimes are the burden for the judicial system. Those with methamphetamine dependence need the medical interventions. Involuntary admission based on the criteria of Mental Health Act is recommended if the subject has the risk of violence or suicide. Methamphetamine induce physical and mental harms. The former included intoxication, cardiovascular and cerebrovascular diseases, and blood-transmitted viral infection. The latter comprised psychosis, depression, suicide and violent behavior. Furthermore, the abusers are more likely to have psychosocial stressors, such as impaired interpersonal function and unemployment. We conducted a long-term follow-up study for the investigation of mortality among the methamphetamine-dependent cohort. Nearly two-third of the deceased died from unnatural causes which could be related to brain harm. One-third died from natural deaths related to physical harm. We deduced methamphetamine damages brain more than the other organs relying on the findings of the distribution of mortality. The present review article formulated systematically the criminal behaviors, physical and mental harms, and mortality induced by methamphetamine that could provide the important evidence-based information for the staff members in fields of forensic addiction medicine and clinical practice.

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