Abstract
Objectives: To determine the laboratory based drug abuse prevalence of persons who have illicit and/or addictive substance test requests instead of alcohol in a city in Middle Anatolia in Turkey. Methods: Laboratory information system’s data of urine samples, submitted to Biochemistry Laboratory from various clinics, between January 2014 and June 2016 were retrospectively investigated. In comprehension of illicit drug use amphetamin, cannabis, opiate, cocaine and benzodiazepin group tests were screened with Cloned Enzyme Donor Immunoassay method. Positivity-negativity rates according to years, age-gender distribution and number of multiple substance usage were investigated. Results: Totally 79873 illicit drugs were screened in 19763 urine samples. 18080 males (% 91.5) and 1683 females (%8.5), with a mean age of 30.7±10.8 years (range: 4-86) and 27.2±10.5 years (range: 1-86) respectively were included. The average positivity rate according to the sample size in last 2.5 years was 23%; 19% in 2014, 23% in 2015, and 27% in 2016. The positivity rates according to number of analyzed tests were 5.9%, 6.7% and 7.5% respectively. In 2014 the maximum positivity rate was in benzodiazepine (12.5%) and secondly in cannabinoids (11.9%). Whereas amphetamine were the most common drug used (16.3%) with a 4.17 fold increase in 2015 compared to 2014. The increase in amphetamine group substance positivity continued in the first half of 2016 compared to previous year. The most common and the second most common multiple substance usage were amphetamine+ cannabis and amphetamine+opiate respectively. Conclusion: According to laboratory information of illicit drug screening results in urine, drug abuse is increasing through years. Amphetamine group is the most common used substance in the last two years in this region. This is the first study contributing to the prevalence of substance use in a city of Middle Anatolia in Turkey with a large sample volume and patient population.

Key words: illicit drug, CEDIA, amphetamine, cannabis

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Laboratuvar verilerine dayalý idrarda yasa dýþý madde analiz sonuçlarýna göre bölgesel madde kullaným yaygýnlýðýnýn belirlenmesi

Özet
Amaç: Türkiye’de bir Ýç Anadolu Bölgesi þehrinde, alkol dýþýndaki yasa dýþý ve/veya baðýmlýlýk yapýcý madde saptanmasý için test istemi yapýlan kiþilerin laboratuvar analizlerine dayalý madde kullanýmý yaygýnlýðýnýn ve yaþ-cinsiyet daðýlýmýnýn belirlenmesi amaçlandý. Yöntem: Ocak 2014-Haziran 2016 yýllarý arasýnda madde analizi yapýlan idrar örneklerine ait laboratuvar bilgi sistemi verileri geriye dönük olarak deðerlendirildi. Madde analizi kapsamýnda amfetamin, kannabis, opiyat, kokain ve benzodiyazepin grubu testler Cloned Enzyme Donor Immunoassay yöntemi ile çalýþýldý. Yýllara göre pozitiflik-negatiflik oranlarý, yaþ-cinsiyet daðýlýmlarý ve çoklu madde kullaným sayýlarý incelendi. Bulgular: Toplam 19763 idrar örneðinde, 79873 yasa dýþý madde analizi yapýldý. 18080’i (%91.5) erkek, yaþ ortalamasý 30.7±10.8 yýl (aralýk: 4-86); 1683’ü (%8.5) kadýn, yaþ ortalamasý 27.2±10.5 (aralýk: 1-86) yýl idi. Son 2.5 yýlda analizi yapýlan toplam numune sayýsýna göre pozitiflik oraný ortalamasý %23; 2014 yýlýnda pozitiflik oraný %19, 2015 yýlýnda %23, 2016 yýlýnda %27 olarak bulundu. Analizi yapýlan test sayýsýna göre pozitiflik oraný ise yýllara göre sýrasýyla %5.9, %6.7 ve %7.5 idi. En fazla pozitiflik oraný 2014 yýlýnda ilk sýrada benzodiyazepin (%12.5) ve ikinci sýrada kannabinoid (%11.9) grubunda iken; 2015 yýlýnda 2014 yýlýna göre 4.17 kat artýþla amfetamin grubu (%16.3) ilk sýrayý aldý. Amfetamin grubu madde kullanýmýndaki anlamlý artýþ 2016 yýlý ilk yarýsýnda da sürdü. Çoklu madde kullanýmýnda da en sýk 'amfetamin+kannabis', ikinci sýklýkta 'amfetamin+opiyat' grubunun olduðu saptandý. Sonuç: Laboratuvar verilerine dayalý idrarda yasa dýþý madde analizi sonuçlarýna göre, yasa dýþý madde kulaným oraný yýllar içerisinde giderek artýþ göstermektedir. Amfetamin grubu madde kullanýmý son yýllarda bölgemizde en sýk kullanýlan baðýmlýlýk yapýcý maddedir ve kannabis kullanýmýnýn önüne geçmiþtir. Geniþ örneklem hacmi ve her türlü amaçla yapýlmýþ laboratuvar analiz verilerinin kullanýldýðý bu çalýþma, bir Ýç Anadolu Bölgesi þehrinde madde kullaným yaygýnlýðýný gösteren ilk çalýþmadýr.

Anahtar Kelimeler: yasadýþý madde, CEDIA, amfetamin, kannabis