ปัญหาการใช้ยากลุ่มเสี่ยงในร้านจำหน่ายพืชกระท่อม จังหวัดอุบลราชธานี

Abstract

Objectives: To develop a monitoring system for the distribution of dangerous drugs used inappropriately among adolescents in Ubon Ratchathani Province. Specifically, the study focuses on three types of dangerous drugs: Tramadol, Dextromethorphan, and Diphenhydramine. Methods: This action research comprises four steps:1. Planning: Analyzing the situation of the distribution of dangerous drugs accessed and misused by adolescents from various sources such as vendors selling stimulants, convenience stores, and current pharmacies.2. Implementation: Developing capabilities among stimulant vendors, convenience stores, and current pharmacies; enhancing the capacities of network agency personnel; and improving the skills of district-level staff.3. Observation: Random field inspections to monitor the distribution of all three types of dangerous drugs in stimulant vendors, convenience stores, and current pharmacies.4. Reflection: Providing feedback to personnel and network agencies, exchanging and learning from the implementation outcomes and encountered obstacles, communicating with and informing the targeted population of both the dangers posed by the three types of dangerous drugs. Results: (1) "Legal proceedings were undertaken against 9 out of 42 stimulant vendors (21.43%) found selling all 3 types of dangerous drugs. The legal actions were distributed as follows: 4 vendors in Mueang district (9.52%), 3 in Warinchamrab (7.14%), and 1 each in Kham Ratanakosin and Bung Bun districts (2.38%). An assessment via the 'Red Rose' Application, conducted in 7,231 convenience stores, identified 248 stores (3.43%) selling all 3 types of dangerous drugs. The most identified stores were in Kham Ratanakosin with 32 (0.44%), followed by Warinchamrab with 30 (0.41%) and Det Udom with 25 (0.35%). (2) Data retrieved from the Food and Drug Administration's SkyNet system regarding current pharmacies that purchased large quantities of all 3 types of dangerous drugs in the fiscal year 2565 (2012) compared to 2566 (2013) showed an increasing trend in Dextromethorphan (both tablets and syrup) and Diphenhydramine. Among current pharmacies, the top three ordering Dextromethorphan were in Warinchamrab, Det Udom, and Phibun Mangsahan. Meanwhile, the top three ordering Diphenhydramine were in Mueang, Warinchamrab, and Det Udom. However, there was a decrease in Tramadol orders. (3) A survey of all state hospitals in Ubon Ratchathani province revealed an increase in patients experiencing adverse effects from all 3 types of dangerous drugs in fiscal year 2565 compared to 2566. For Tramadol, cases increased in Mueang (15.20%) and Warinchamrab (9.60%), as well as in Kham Ratanakosin and Khong Chiam, each at 4.80%. Dextromethorphan led to increased adverse effects in Mueang (71.43%) and Warinchamrab and Sri Mueang Mai, each at 3.57%. Diphenhydramine caused increased adverse effects in Mueang at 81.82% .Conclusion: From data collected from stimulant vendors facing legal proceedings for selling all three types of dangerous drugs, convenience stores retailing all three types of dangerous drugs, current pharmacies ordering these three types in large quantities, and hospital records of patients suffering from adverse drug effects, these insights will be utilized to enhance the monitoring system for the distribution of commonly abused dangerous drugs among adolescents in Ubon Ratchathani province. The issues identified in drug distribution outlets (stimulant vendors/current pharmacies) and among patients facing adverse effects at each state hospital will serve as focal points for developing a network and managing the risk associated with the improper use of dangerous drugs among adolescents in Ubon Ratchathani province. Subsequently, the goal is to expand and sustain the development of the monitoring system for the distribution of dangerous drugs among adolescents in Ubon Ratchathani province in the long run.

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