Newsletter No. 396

4 No. 396, 19.4.2012 I t was reported in the newspaper that the Northern Hospital received 126 drug abuse cases last year, and 44% of the patients were found to have hyperactive bladders. Four were seriously ill, and among them a 14-year-old boy suffered severe reduction of urinary bladder capacity to just 90 ml, i.e., less than a tiny Yakult drink. The shrunk bladder is caused by cystitis, a condition commonly seen after prolonged abuse of ketamine, a psychoactive drug. Patients are toilet-bound and life becomes a nightmare. Fortunately, some patients were able to recover part of their bladder function when they stopped abusing drugs. These stories are all too familiar to Prof. Cheung Yuet-wah , chairman of the Department of Sociology, CUHK, whose research interests are in crime and deviance, substance abuse, and medical sociology, including alcoholism and drug abuse. He had just finished a research project on adolescent abuse of psychoactive drugs in Hong Kong sponsored by the Beat Drugs Fund. The research employed a longitudinal research design to survey more than 700 young drug abusers. Each of them was interviewed once every six months, and altogether six rounds of interviews were conducted from 2009 to 2011. Also, focus groups comprising young drug abusers were formed to collect in-depth information on their drug taking habits. Professor Cheung remembered a 28-year- old long-term ketamine abuser who used to describe his experience in great detail. Now regretful of his behaviour, he volunteered to share his story with secondary school students. His greatest trouble is he needs to go to toilet every 10 minutes or so. That means going out or taking the bus or MTR, etc., is not possible at all. In the past 15 years, Professor Cheung has conducted extensive research on substance abuse and drug policy in Hong Kong. ‘The stomach will get into trouble first, followed by the heart, liver, kidneys and bladder. If parents found their children suffer from stomach-aches for no obvious reason, this could be a sign. If this is accompanied by frequent urges to urinate, it’s something worth noticing,’ he said. From the end of WWII to the 1990s, the main drug problem in Hong Kong was heroin. From the mid-1990s onwards, the types of drugs abused diversified, and an upsurge in psychoactive drug abuse was recorded, said Professor Cheung. Besides trying to curb the supply and 報 載北區醫院去年處理了一百二十六宗濫藥個案，發 現四成四人膀胱過度活躍，有四人更情況嚴重， 其中一名只有十四歲的少年因為長期濫用俗稱K仔的氯胺 酮，刺激膀胱壁增厚，膀胱容量減少至只有九十毫升，即少 於一瓶益力多，需要頻密如廁，苦不堪言。少年戒掉惡習 後，膀胱功能才有少許改善。 類似個案對中大社會學系系主任 張越華 教授一點不陌生。 他專研犯罪與越軌、藥物濫用及醫療社會學，一直關注酗 酒和吸毒問題，剛完成了一項由禁毒基金資助的香港青少 年濫用精神藥物的研究。研究採用縱貫性問卷調查，以 七百多名濫藥青少年為對象，每半年訪問一次，在2009至 2011年間內共進行了六次。此外，該研究亦組織多個濫藥 青少年焦點小組，探究他們的濫藥經驗。最令張越華難忘 的是一名二十八歲的青年，濫用K仔等已十年， 時常滔滔不絕談論自己的經歷。他現在 最大的煩惱是每十分鐘便要上洗 手間，乘搭交通工具已不可 能。他希望能以過來人身 分到學校勸誡中學生不要 濫藥。 過去十五年，張教授進行了多項 香港藥物濫用及藥物政策的研究，他 說：「濫用K仔，最先及最容易受損的器 官是胃，其他如心、肝、腎和膀胱也陸續受影 響。家長如果發覺孩子時常無緣無故胃痛，很可能是一個 警號。如果小便亦見頻繁，更不容忽視。」 他解釋，二次大戰後到九十年代中肆虐香港的毒品是俗稱 「白粉」的海洛英，九十年代中開始，毒品種類多樣化，青 少年使用精神藥物人數大幅上升，政府除了禁制，亦開始 着重預防教育及康復服務，對毒品問題的研究也愈來愈 多。「上世紀末，全球青少年濫藥問題突趨嚴重，歐美尤其 厲害。1998年，英國社會學家 霍華德 ‧ 帕克 教授發表了研 究報告，主題是頗為震撼的『消遣性濫藥的正常化』，指 出在的士高或派對上，服用精神藥物變得普遍，愈來愈多 青少年以這種方法消遣。香港今天正正是這個樣子。」 據張教授的研究，現時香港的濫藥者已經不限於邊緣青年 或者讀書不成的學生，不少是普通學生和有正當工作的年 輕一代。令人擔憂的是不少濫用精神藥物的青少年，認為 這只是一種壞習慣，和吸煙、上網、打機、賭博沒有甚麼分 別。「他們不覺得是吸毒，沒有危險意識。現在的濫藥者主 要『索K』，表面上與常人無異。而且『濫藥』和『吸毒』在 詞義上有輕重之分。因此，現時政府宣傳上多用了『吸毒』 一詞，提醒青少年不要輕視服用違禁藥物的嚴重後果。」 張教授接觸的濫藥青少年都說，在家索K父母不易察覺， 在學校洗手間或課節交替時在課室內索K亦易如反掌。張 教授稱，現在已進入「毒品新時代」，鑑於本地戒毒服務一 向針對海洛英毒癮，要轉為治療濫用精神藥物人士，是急 需深入探討和評估的。此外，濫用精神藥物的青少年成長 後，生活方式轉變，未必能像昔日一樣參加K仔派對。踏入 人生下一階段，索K一族會不會轉而吸食白粉，也是有必要 研究及監察的問題。 身為現任香港社會學會會長，以及亞洲犯罪學會創會會員 的張教授指出，「過去十年社會發展急遽，競爭愈來愈大， 青少年對未來感到天地茫茫，無所適從，索K是某些人在 面對艱難的社會現實時的反應。」他說︰「濫藥是青少年 問題，也是社會問題。我們營造了怎樣的社會，便有怎樣的 青少年問題。要有效防止毒品或者其他危險的成癮行為侵 害，最好還是從研究青少年文化上着手，才會事半功倍。」 青少年濫藥與解窘 Adolescent Drug Abuse and the Way Out consumption of psychoactive drugs, the government also stressed prevention and rehabilitation. During that time, more research on drug abuse was conducted. ‘By the end of the 20th century, drug abuse among young people worsened and it became a global issue, especially in Europe. In 1998, a British sociologist Howard Parker in his research used ‘normalization of recreational drug use’ to describe this stunning phenomenon. Drug-taking in discos and parties is common, and more young people see it as a way to spend their leisure time. The same is occurring in Hong Kong now.’ Findings from Professor Cheung’s research reveal that drug abuse in Hong Kong is not limited to marginal youths or those who do poorly in school, but also found in ordinary students or young people with decent jobs. The biggest worry is young people tend to think taking psychoactive drugs is a bad hobby, just like smoking, Internet surfing, playing online games and gambling. ‘They do not see taking psychoactive drugs as “drug abuse”, and thus become insensitive to the danger. Ketamine is now the most popular drug, and ketamine users look normal just like anyone else. Semantically, “drug abuse” is less severe than “drug addiction”. Therefore, the government now uses “drug addiction” more often in public campaigns, to remind young people not to overlook the serious consequences of drug abuse.’ Young abusers always tell Professor Cheung that it is easy to take drugs at home without parents knowing. Taking drugs in school toilets and classrooms during breaks are also easy. Professor Cheung said we have entered a new drug era. Since the conventional treatment programmes are mainly targeted at heroin addicts, if we use them to treat psychoactive drug abusers, detailed investigation and assessment are urgently required. Besides, as young abusers grow older, they would take up different roles and cultivate different lifestyles, and might not participate in doping parties as often as they usually did. What would happen if they move on and face the next stage in life? Would ketamine abusers later shift to heroin? This requires more research and monitoring. ‘Society has changed a lot in the past decade and competition is growing fierce. Young people feel helpless and lack direction. Some numb their senses through drug abuse in order to cope with harsh reality,’ observed Professor Cheung, who is the current president of the Hong Kong Sociological Association and a founding member of the Asian Criminological Society. ‘Drug abuse is a youth problem, as well as a social problem. The society is our own making, and so is the kind of youth problem we have. In order to prevent young people from abusing illicit drugs or indulge in other risky behaviour, we need to do more research to understand adolescents’ subculture and penetrate into the core of the problem,’ he commented.