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(1) \u7576\u5438\u6bd2\u5bb6\u4eba\u51fa\u73fe\u6025\u6027\u7cbe\u795e\u75c5\u5fb5\u72c0\u6642\uff0c\u9996\u5148\u8981\u6ce8\u610f\u4eba\u8eab\u5b89\u5168\u3002\u82e5\u60c5\u51b5\u975e\u5e38\u7dca\u6025\uff0c\u4f8b\u5982\u5438\u6bd2\u8005\u50b7\u5bb3\u81ea\u5df1\u6216\u5225\u4eba\uff0c\u8acb\u7acb\u5373\u5831\u8b66\u6c42\u52a9\uff0c\u4e26\u96e2\u958b\u73fe\u5834\u6216\u5c0b\u627e\u4e00\u500b\u5b89\u5168\u5730\u9ede\u7b49\u5f85\u652f\u63f4\uff1b<\/p>\n

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\u524d\u7dda\u7684\u6212\u6bd2\u5de5\u4f5c\u54e1\u6bcf\u5929\u8981\u8655\u7406\u5927\u91cf\u8907\u96dc\u500b\u6848\uff0c\u540c\u6642\u53c8\u8981\u517c\u9867\u793e\u5340\u6559\u80b2\uff0c\u9762\u5c0d\u6392\u5c71\u5012\u6d77\u7684\u5de5\u4f5c\uff0c\u8981\u5354\u52a9\u5438\u6bd2\u8005\u53ca\u5176\u5bb6\u4eba\uff0c\u8ac7\u53ef\u5bb9\u6613\uff01<\/p>\n

\u4ee5\u4e0b\u5e7e\u9ede\u610f\u898b\uff0c\u4f9b\u6709\u5fc3\u4eba\u53c3\u8003\u548c\u8a0e\u8ad6\ufe55<\/p>\n

(1) \u4ee5\u5148\u5c0e\u8a08\u5283\u6210\u7acb\u8de8\u5c08\u696d\u793e\u5340\u6212\u6bd2\u652f\u63f4\uff1a\u5f37\u5316\u793e\u5340\u6212\u6bd2\u8f14\u5c0e\u4e2d\u5fc3\uff08CCPSA\uff09\u3001\u7cbe\u795e\u5065\u5eb7\u7d9c\u5408\u793e\u5340\u4e2d\u5fc3\uff08ICCMW\uff09\u3001\u7269\u8cea\u8aa4\u7528\u8a3a\u6240\uff08SAC\uff09\u3001\u6212\u6bd2\u4f4f\u5bbf\u670d\u52d9\u5718\u9ad4\u548c\u5bb6\u5ead\u7d9c\u5408\u670d\u52d9\u4e2d\u5fc3\uff08IFSC\uff09\u7684\u5354\u4f5c\uff0c\u4fc3\u9032\u5c08\u696d\u4ea4\u6d41\u4e26\u5efa\u7acb\u5408\u4f5c\u5e73\u53f0\uff0c\u70ba\u5438\u6bd2\u5bb6\u5ead\u63d0\u4f9b\u6574\u5168\u7684\u5354\u52a9\u3002<\/p>\n

(2) \u63d0\u4f9b\u51fa\u9662\u548c\u96e2\u820d\u652f\u63f4\u5b89\u6392\ufe55\u5021\u8b70\u91ab\u9662\u7269\u8cea\u6feb\u7528\u670d\u52d9\u7684\u4f4f\u9662\u90e8\u8207\u6212\u6bd2\u6751\u6216\u6212\u6bd2\u4e2d\u9014\u5bbf\u820d\uff0c\u5efa\u7acb\u652f\u63f4\u6027\u51fa\u9662\u63a5\u99c1\u670d\u52d9\uff0c\u4ee5\u8de8\u5c08\u696d\u5354\u4f5c\u7684\u6a21\u5f0f\uff0c\u7d44\u7e54\u91ab\u751f\u3001\u793e\u5eb7\u8b77\u58eb\u3001\u8077\u696d\u6cbb\u7642\u5e2b\u548c\u793e\u5de5\uff0c\u8a2d\u8a08\u6709\u7cfb\u7d71\u3001\u91dd\u5c0d\u6027\u548c\u6cbb\u7642\u6027\u7684\u91cd\u8fd4\u793e\u5340\u5fa9\u5eb7\u7642\u7a0b\u3002\u82e5\u6848\u4e3b\u7cbe\u795e\u72c0\u51b5\u4e0d\u7406\u60f3\uff0c\u53ef\u555f\u52d5\u8fd4\u56de\u6a5f\u5236\u5728\u91ab\u9662\u63a5\u53d7\u8ddf\u9032\u6cbb\u7642\uff0c\u4e00\u65b9\u9762\u53ef\u76e1\u5feb\u8b93\u5438\u6bd2\u8005\u5f97\u5230\u9069\u5207\u7684\u652f\u63f4\uff0c\u540c\u6642\u4ea6\u907f\u514d\u4e86\u5bb6\u4eba\u6574\u5929\u6182\u5fc3\u5fe1\u5fe1\uff0c\u64d4\u5fc3\u524d\u8005\u7559\u5728\u5bb6\u4e2d\u505a\u51fa\u50b7\u5bb3\u81ea\u5df1\u6216\u4ed6\u4eba\u7684\u884c\u70ba\u3002<\/p>\n

(3) \u63d0\u4f9b\u6709\u7cfb\u7d71\u548c\u5c08\u9580\u7684\u6210\u766e\u548c\u7cbe\u795e\u5065\u5eb7\u57f9\u8a13\u8ab2\u7a0b\uff0c\u4fc3\u9032\u8de8\u5c08\u696d\u5b78\u7fd2\uff0c\u52a0\u5f37\u524d\u7dda\u6212\u6bd2\u5de5\u4f5c\u54e1\u7684\u5c08\u696d\u77e5\u8b58\u548c\u6280\u5de7\u3002<\/p>\n

\u6587\uff1a\u8b1d\u5bb6\u548c\uff08\u9999\u6e2f\u5927\u5b78\u793e\u6703\u5de5\u4f5c\u53ca\u793e\u6703\u884c\u653f\u5b78\u7cfb\u6e96\u535a\u58eb\uff09\u3001\u5289\u9821\u5049\uff08\u8a3b\u518a\u793e\u5de5\uff09<\/p>\n

\u7de8\u8f2f\uff1a\u8521\u66c9\u5f64<\/p>\n

https:\/\/health2.mingpao.com\/ftp\/Health2\/20170821\/news\/_21yc101.jpg\u75c5\u8b58\u611f\u4f4e\u2014\u2014\u51b0\u6bd2\u5f15\u767c\u6025\u6027\u7cbe\u795e\u75c5\u72c0\u614b\uff0c\u4f46\u60a3\u8005\u300c\u75c5\u8b58\u611f\u300d\u4f4e\uff0c\u793e\u5de5\u96e3\u4ee5\u63d0\u4f9b\u5354\u52a9\uff0c\u5c0d\u5bb6\u4eba\u7684\u652f\u63f4\u66f4\u52a0\u7f3a\u4e4f\u3002\uff08\u5716\uff1aSasinParaksa@iStockphoto\u3001kaarsten@iStockphoto\uff09;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170821\/news\/_21yc102.jpg\u5c0b\u6c42\u5c08\u696d\u8f14\u5c0e\u2014\u2014\u5438\u6bd2\u8005\u5bb6\u4eba\u61c9\u53ca\u65e9\u5c0b\u6c42\u5c08\u696d\u8f14\u5c0e\uff0c\u5f9e\u540c\u884c\u8005\u8eab\u4e0a\u5f97\u5230\u652f\u6301\uff0c\u5b78\u7fd2\u65b0\u7684\u77e5\u8b58\u548c\u61c9\u5c0d\u65b9\u6cd5\u3002\uff08\u5716\uff1astask@iStockphoto\uff09;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】近年經常聽到「隱蔽吸毒者」一詞，但世上會有「顯性吸毒者」嗎？吸毒在香港是犯法行為，很難想像有人會事無忌憚地公然吸毒。新的標籤不但無助解決問題，反而令服務焦點模糊，忽略了吸毒者和家人之間的互動和掙扎。<\/p>\n

個案分享：<\/p>\n

陳太：「我懷疑兒子（化名：明仔）染了不良習慣，家中發現了一些疑似吸食冰毒的工具。他近日表現很不尋常，經常向我投訴樓上單位發出噪音，更不時走到鄰居單位前大吵大鬧要對方安靜。有時明仔又會慌張地走出房間，把家中的電器拆開，說當中隱藏了偷聽器。大部分時間他不會踏出房門半步，但每天也會有一段時間外出，大概15分鐘便回來。我特意走入他房間查看，發現他把窗花也拆掉了。究竟發生什麼事呢？」<\/p>\n

誠然，吸毒者有自身的掙扎。明仔曾表示﹕「我內心很不安，現在所感受到的、聽到的、看到的幻覺好像是真的。我對家人說，但他們不會明白我，我該怎辦呢？」<\/p>\n

同時，家人目睹明仔情緒和行為失控，也不知如何是好。陳太心裏忐忑﹕「報警處理可行嗎？明仔會否從此不再信任我？找社工可行嗎？我要求明仔到中心接受服務，但他總是一口拒絕。我感無能為力了，亦失眠了多天。誰人可以給我一點支持呢？」<\/p>\n

類似個案，每天都在社區上演，從中可以感受到吸毒者家人的苦况和無奈。<\/p>\n

保安局禁毒處藥物濫用資料中央檔案的最新統計數字顯示，本港整體呈報的吸毒人數持續下降，較去年少8%（由8767人下降至8077人）；而21歲以下的青少年吸毒人數更顯著下降27%（由689人下降至502人），當中吸食氯胺酮的大幅減少超過五成（52.4%）。<\/p>\n

冰毒癮者「病識感」低 少主動求助 <\/p>\n

然而，首次被呈報吸食冰毒的人數卻上升超過四分之一（27.5%），吸食大麻的增幅亦達兩倍。正是吸食毒品的類型改變了，所帶來的身體傷害和衍生的家庭問題亦與以往大為不同。<\/p>\n

首先，冰毒這種興奮劑能引發使用者出現如急性精神病狀態（acute psychosis）、急性混亂狀態（acute confusion state）、譫妄（delirium）等徵狀。患者的「病識感」低，主動求助的動機相對減少，社工要評估和提供協助就變得更為困難。<\/p>\n

此外，吸毒行為從娛樂場所或隱蔽街角轉移到家中，更令「毒戰」天天在吸毒者和家人之間上演。部分家人因為擔心吸毒者做出傷害自己或他人的行為，同時又不懂應對，於是對吸毒者採取操控和監視行為，結果進一步削弱彼此之間的互信，影響家庭功能和患者病情，亦對其他家人的精神健康構成影響。家庭氣氛欠佳，要復元就更困難。<\/p>\n

互累症 與家人「毒戰」<\/p>\n

這種失衡的依附狀態，學術上稱之為互累症（Codependency），普遍出現於吸毒、酗酒、賭博失調症及其他精神病患者的家庭關係中。然而過往許多社福機構也將戒毒治療和輔導資源集中在吸毒者身上，家人獨力面對問題，身心之疲乏可想而知。<\/p>\n

尋求專業支援 有同路人分擔<\/p>\n

以下是給家人的幾個小貼士：<\/p>\n

(1) 當吸毒家人出現急性精神病徵狀時，首先要注意人身安全。若情况非常緊急，例如吸毒者傷害自己或別人，請立即報警求助，並離開現場或尋找一個安全地點等待支援；<\/p>\n

(2) 若有精神科護士、戒毒輔導員或社工跟進，請與相關專業人士保持緊密聯繫，共謀對策；<\/p>\n

(3) 避免刺激和辱罵家中有急性精神病狀態的吸毒者；<\/p>\n

(4) 及早尋求專業支援，減低獨力面對問題的壓力，並從同行者身上獲得支持。很多濫藥者家人面對相同困境，多參加由社區戒毒輔導中心（CCPSA）組織的家屬小組，可從同路人身上學習到新的知識和應對方法，有效減輕壓力。<\/p>\n

有吸毒者家長曾言，「要幫家人戒毒，就要先幫自己。這是一條漫漫長路」。學習愛惜自己，注意個人身體健康和精神狀况，尋求助人專業者協助，並和同路人彼此扶持，才能成為吸毒者家人的同行者，令家庭踏上復元之路。<\/p>\n

跨專業社區戒毒支援特遣隊<\/p>\n

聞「吸毒隱蔽化」一詞多年，吸毒者家人的無助呼聲依然未得到回應。吸毒問題成因複雜，影響範圍廣而深。成立跨專業社區戒毒支援特遣隊，有助大家集思廣益，整合社區資源，並填補不同專業的服務和知識空隙，織出強大社區戒毒復康支援網絡，為受吸毒問題困擾的家庭提供多角度和整全的支援。<\/p>\n

■專家札記<\/p>\n

多個專業支援 提供整全協助<\/p>\n

前線的戒毒工作員每天要處理大量複雜個案，同時又要兼顧社區教育，面對排山倒海的工作，要協助吸毒者及其家人，談可容易！<\/p>\n

以下幾點意見，供有心人參考和討論﹕<\/p>\n

(1) 以先導計劃成立跨專業社區戒毒支援：強化社區戒毒輔導中心（CCPSA）、精神健康綜合社區中心（ICCMW）、物質誤用診所（SAC）、戒毒住宿服務團體和家庭綜合服務中心（IFSC）的協作，促進專業交流並建立合作平台，為吸毒家庭提供整全的協助。<\/p>\n

(2) 提供出院和離舍支援安排﹕倡議醫院物質濫用服務的住院部與戒毒村或戒毒中途宿舍，建立支援性出院接駁服務，以跨專業協作的模式，組織醫生、社康護士、職業治療師和社工，設計有系統、針對性和治療性的重返社區復康療程。若案主精神狀况不理想，可啟動返回機制在醫院接受跟進治療，一方面可盡快讓吸毒者得到適切的支援，同時亦避免了家人整天憂心忡忡，擔心前者留在家中做出傷害自己或他人的行為。<\/p>\n

(3) 提供有系統和專門的成癮和精神健康培訓課程，促進跨專業學習，加強前線戒毒工作員的專業知識和技巧。<\/p>\n

文：謝家和（香港大學社會工作及社會行政學系準博士）、劉頡偉（註冊社工）<\/p>\n

編輯：蔡曉彤<\/p>\n

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