Faktor Risiko Gangguan Kognitif pada Penyalahguna Narkoba di Enam Balai Rehabilitasi Badan Narkotika Nasional Tahun 2019
Risk Factor for Cognitive Impairement in Drug Abuser in Six Rehabilitation Center for National Narcotics Board in 2019
Abstract
In 2018, more than a quarter-billion people worldwide used drugs. Continuous use of drugs can cause changes in the nervous system of the brain. The purpose of this analysis was to identify risk factors for cognitive impairment in drug abusers. This research is a secondary data analysis from a crosssectional study of Health Research on the Impact of Drug Abuse conducted by the National Narcotics Board at the BNN Rehabilitation Center. The dependent variable in this study is sociodemography, duration of drug use, age at first using drugs, the number of substances used and, the type of drugs used. While the independent variable is cognitive impairment. The data analyzed were 601 drug abusers aged 15-50 years. Data analysis used descriptive, bivariate and, multivariate cox regression. The results showed that the factors associated with cognitive impairment in drug abusers were the use of marijuana (PR=1.33: p=0.007) and prescription drugs abuse (PR=1.26: p=0.046). Cognitive impairment in drug abusers in this study was associated with the use of cannabis and triheksifenidil and dekstrometrofan abuse. These findings provide recommendation for rehabilitation administrators to use cognitive impairment examination results as a determination of treatment plan for rehabilitation clients and become recommendation for the government to formulate policies related to drug abuse that are more comprehensive in terms of production, distribution and buyers / abusers.
Abstrak
Pada tahun 2018, lebih dari seperempat milyar orang di seluruh dunia menggunakan narkoba. Penggunaan narkoba secara terus-menerus dapat menyebabkan perubahan pada sistem syaraf otak. Tujuan analisis ini adalah mengidentifikasi faktor risiko gangguan kognitif pada penyalahguna narkoba. Penelitian ini merupakan analisis data sekunder dari studi cross sectional Riset Kesehatan Dampak Penyalahgunaan Narkoba yang dilakukan oleh Badan Narkotika Nasional (BNN) di enam Balai Rehabilitasi BNN. Variabel terikat dalam penelitian ini adalah lama pemakaian narkoba, usia pertama kali menggunakan narkoba, jumlah zat yang digunakan dan jenis narkoba yang digunakan. Sedangkan variabel bebas ialah gangguan kognitif. Data yang dianalisis sebanyak 601 orang penyalahguna narkoba yang berusia 15-50 tahun. Analisis data menggunakan deskriptif, bivariat dan multivariat dengan cox regression. Hasil penelitian menunjukkan faktor yang berhubungan dengan gangguan kognitif pada penyalahguna narkoba adalah penggunaan ganja (PR=1,33: p=0,007) dan penyalahgunaan triheksifenidil dan dekstrometrofan (PR=1,26: p=0,043). Gangguan kognitif pada penyalahguna narkoba pada penelitian ini terkait dengan penggunaan narkotika jenis ganja dan penyalahgunaan triheksifenidil dan dekstrometrofan. Temuan ini memberikan masukan bagi penyelenggara rehabilitasi untuk menjadikan hasil pemeriksaan gangguan kognitif sebagai dasar penentuan rencana pengobatan bagi klien rehabilitasi dan menjadi masukan bagi pemerintah untuk menyusun kebijakan terkait penyalahgunaan obat daftar G yang lebih komprehensif baik dari sisi produksi, distribusi dan pembeli/penyalahguna.
References
United Nations Office on Drugs and Crime. The world drug report [Internet]. United Nations publication. 2019. 1–4 p. Available from: https://www.unodc.org/doc/wdr2016/WORLD_DRUG_REPORT_2016_web.pdf
Hidriyah S. Mengapa Indonesia menjadi sasaran sindikat narkoba internasional. Info Singk [Internet]. 2015;X:12. Tersedia di: http://berkas.dpr.go.id/puslit/files/info_singkat/Info Singkat-X-5-I-P3DI-Maret-2018-229.pdf
Badan Narkotika Nasional. Survei prevalensi 2018. 2019. 1–132 p.
Humas BNN. Pengertian narkoba dan bahaya narkoba bagi kesehatan [Internet]. www.bnn.go.id. 2019 [cited 2021 Apr 28]. Tersedia di: https://bnn.go.id/pengertian-narkoba-danbahaya-narkoba-bagi-kesehatan/
Republik Indonesia. Peraturan Menteri Kesehatan Nomor 4 Tahun 2020 tentang Penyelenggaraan Institusi Wajib Lapor. Kementerian Kesehatan RI. Jakarta; 2020.
Badan Narkotika Nasional, Kementrian Kesehatan RI UA. Riset kesehatan dampak penyalahgunaan narkoba 2019. 2019. 1–148 p.
Lewis M. Brain change in addiction as learning, Not Disease. N Engl J Med. 2018;379(16):1551–60.
Bassiony MM, Youssef UM, Hassan MS, Salah El-Deen GM, El-Gohari H, Abdelghani M, et al. Cognitive impairment and tramadol dependence. J Clin Psychopharmacol. 2017;37(1):61–6.
M. Christopher AMLS. Animal models of addiction: Compulsive drug taking and cognition. Physiol Behav. 2019;176(1):100–106.
Yustiana AV, Alit Aryani LN. Gangguan psikotik akibat penggunaan ganja (cannabis): studi kasus. Medicina (B Aires). 2019;50(2):400-3
Sari WN, Sri S, Gofir A. Penyalahgunaan narkotika, psikotropika, dan zat adiktif sebagai faktor risiko gangguan kognitif pada remaja jalanan. Berk Neurosains. 2016;15(2):85–95.
McInnes K, Friesen CL, MacKenzie DE, Westwood DA, Boe SG. Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS One. 2017;12(4).
Bruijnen CJWH, Dijkstra BAG, Walvoort SJW, Markus W, VanDerNagel JEL, Kessels RPC, et al. Prevalence of cognitive impairment in patients with substance use disorder. Drug Alcohol Rev. 2019;38(4):435–42.
Midi H, Sarkar SK, Rana S. Collinearity diagnostics of binary logistic regression model. J Interdiscip Math. 2010;13(3):253–67.
Yoo W, Mayberry R, Bae S, Singh K, He Q, Lillard Jr. JW. A study of effects of multicollinierity in multivariable analysis. Int J Appl Sci Technol. 2014 Oct;4(5):9-19
Viktorov VA, Varin AN, Grinval’d VM, Maksimov EP, Fomicheva NN, Zavalishin YK, et al. Current state and prospects for development of domestic equipment for hemodialysis with dialyzate regeneration. Biomed Eng (NY).2003;37(1):16–21.
Van der Net JB, Janssens ACJW, Eijkemans MJC, Kastelein JJP, Sijbrands EJG, Steyerberg EW. Cox proportional hazards models have more statistical power than logistic regression models in cross-sectional genetic association studies. Eur J Hum Genet. 2008;16(9):1111–6.
Ingrid D, Brunier A, Sharma H. World Mental Health Day: an opportunity to kick-start a massive scale-up in investment in mental health. World Heal Organ [Internet]. 2020;1–5. Available from: https://www.who.int/news-room/detail/27-08-2020-world-mental-health-day-an-opportunityto-kick-start-a-massive-scale-up-ininvestmentin-mental-health
Castellanos-Ryan N, Pingault JB, Parent S, Vitaro F, Tremblay RE, Séguin JR. Adolescent cannabis use, change in neurocognitive function, and high-school graduation: A longitudinal study from early adolescence to young adulthood. Dev Psychopathol. 2017;29(4):1253–66.
Figueiredo PR, Tolomeo S, Steele JD, Baldacchino A. Neurocognitive consequences of chronic cannabis use: a systematic review and meta-analysis. Neurosci Biobehav Rev [Internet]. 2020;108(October 2019):358–69. Tersedia di: https://doi.org/10.1016/j.neubiorev.2019.10.014
Ross JM, Ellingson JM, Rhee SH, Hewitt JK, Corley RP, Lessem JM, et al. Investigating the causal effect of cannabis use on cognitive function with a quasi-experimental co-twin design. Drug Alcohol Depend. 2020;206
National Institute on Drug Abuse. Misuse of prescription drugs research report. 2020;(June):1–29. Tersedia di: https://www.drugabuse.gov/publications/research-reports/misuseprescription-drugs/what-scope-prescriptiondrug-misuse
Indonesia R. Peraturan Badan POM no 28 tahun 2018 tentang Pedoman Pengelolaan Obat-obatan
Tertentu yang sering Disalahgunakan. Badan Pengawas Obat dan Makanan. 2018;1–40.
Semarang DIK. Gambaran Penggunaan napza pada anak jalanan di Kota Semarang. J Kesehat Masy. 2014;9(2):137–43.
Fatmawati D. Upaya Balai Besar Pengawas Obat Dan Makanan (BBPOM) dalam meningkatkan pengawasan obat di Kota Samarinda. eJournal Ilmu Pemerintah. 2019;7(3):1351–64.
Raji Saheed O. Trihexyphenidyl abuse in psychiatric outpatient clinic of a general hospital in Northern Nigeria. J Addict Med Ther Sci. 2020;6(1):003–8.
Thunyapipat C, Manaboriboon B, In-iw S, Kriengsoontornkij W. A case series of trihexyphenidyl Abuse for Recreational Purpose in Thai children and adolescents. J Adolesc Heal [Internet]. 2018;62(2):S137. Tersedia di: https://doi.org/10.1016/j.jadohealth.2017.11.280
Torrents R, Ferré JF, Konareff A, Hemery P, Sherwin K, Lassalle C, et al. Misuse of Trihexyphenidyl (Artane) on Réunion Island. J Clin Psychopharmacol. 2018;38(3):250–3.
Stanciu CN, Penders TM, Rouse EM. Recreational use of dextromethorphan, “Robotripping” - A brief review. Am J Addict. 2016;25(5):374–7.
Mclellan T, Carise D, Coyne TH, Jackson TR. Addiction severity index - 5th edition clinical / Training Version. Tersedia di : https://my.ireta.org/sites/ireta.org/files/ASI%20form.pdf
Heriyanto M, Hidayatullah W, Mulyadi M. Konsep kriminalisasi penegakan hukum terhadap pembeli aktif ilegal obat keras daftar “G” Jenis trihexyphenidil. Media Iuris. 2020;3(1):57.
